Basic History
 

Alcohol History-Taking

 
 
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Overview

  • Alcohol abuse, binging and dependence is very common in the community, and can result in significant acute and chronic complications. A tactful history will aid in understanding the patient's pattern of alcohol intake and their attitude toward alcohol.
    • Ask About

    • Everyone

    • Whether they drink alcohol regularly
    • How often - daily, weekly, monthly, or on social occasions only
    • What type of alcohol they drink
    • How many drinks on each occasion / each day
    • The most they drink at any given time
    • Where they drink - restaurants, bars, parties, at home
    • Amount spent on alcohol
    • Heavy Drinkers

    • Withdrawal symptoms - sweating, rigors, nausea, past seizures
    • Alcohol free days
    • Past attempts to quit drinking
    • Willingness to cut down or stop
    • Consequences of Alcohol Abuse

    • Oesophagitis
    • Pancreatitis
    • Alcoholic liver disease - steatosis, hepatitis, cirrhosis
    • Cardiovascular disease - hypertension, dilated cardiomyopathy, atrial fibrillation
    • Neurologic complications - Wernicke encephalopathy, Korsakoff syndrome, cerebellar atrophy, peripheral neuropathy, myopathy
    • Malignancy - mouth, oesophagus, throat, liver, breast
    • Bone marrow suppression
    • Osteoporosis
    • Malnutrition
    • Trauma - high risk behaviour, MVA
    • Psychiatric disorders - depression, anxiety, suicide

The CAGE questionnaire

  • A screening tool for alcohol dependence.
    • Ask About

    • Cut down - have they ever felt that they should cut down on their drinking?
    • Annoyed - do they get annoyed when other people talk to them about how much they drink?
    • Guilty - have they ever felt guilty about something they did as a result of their drinking
    • Eye opener - do they use alcohol to help them wake up in the morning?

What is a Standard Drink?

  • One standard drink in Australia contains 10g of alcohol.
    • One Standard Drink

    • Beer

    • 285mL full strength beer (4.8%) - 1.1 standard drinks
    • 375mL full strength beer (4.8%) - 1.4 standard drinks
    • 425mL full strength beer (4.8%) - 1.6 standard drinks
    • 285mL mid strength beer (3.5%) - 0.8 standard drinks
    • 375mL mid strength beer (3.5%) - 1 standard drink
    • 425mL mid strength beer (3.5%) - 1.2 standard drinks
    • 285mL low strength beer (2.7%) - 0.6 standard drinks
    • 375mL low strength beer (2.7%) - 0.8 standard drinks
    • 425mL low strength beer (2.7%) - 0.9 standard drinks
    • Wine

    • 150mL red wine (13%) - 1.5 standard drinks
    • 150mL white wine (11.5%) - 1.4 standard drinks
    • 150mL sparkling wine (12%) - 1.4 standard drinks
    • 60mL port (17.5%) - 1.4 standard drinks
    • Spirits

    • 30mL standard spirit (40%) - 1 standard drink
 
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