Index

Technical Report Documentation Page

Executive Summary

Background

Methods and Outcomes

Conclusions

References

Appendix

Appendices

OBJECTIVES:

  • Know the prevalence of alcohol problems and how you could become involved

  • Know the outcome literature on Brief Interventions

  • Learn screening, assessment, and brief intervention skills for your setting

 

What is a
"BRIEF INTERVENTION"?

  • A carefully crafted effort

  • Sometimes only a few sentences by a provider

  • Designed to raise the chances that a patient/client will make a change

 

Terms, Terms, Terms:

Terms, Terms, Terms Pyramid

 

Low-Risk Drinker:

Men: 3-4/day max & 15/wk. max

Women: 2-3/day max & 10/wk. max

"1 drink"

= 12-oz beer
= 5-oz wine
= single mixed drink

 

Alcohol Abuse
(meets > 1 in past year)

  1. Recurrent use causes failed role obligations

  2. Recurrent use in hazardous situations
    (e.g. driving)

  3. Recurrent legal problems related to use

  4. Continues use despite having problems caused/exacerbated by use

 

ALCOHOL DEPENDENCE
(meets > 3 of 7 within past year:)

  • W ithdrawal symptoms

  •  I  nvolved, too much time spent

  •  T olerance to drug's effects

  • H ampered activities, responsibilities

  • D esires to quit but has not done so

  • R epeats use despite knowing of problem

  • L arger amounts than intended

 

RED FLAGS
for Problem Drinking:

  • Hypertension
  • Liver dysfunction
  • Sleep disorders
  • Sexual dysfunction
  • Depression
  • Blackouts
  • Trauma
  • Prescription drug use
  • Chronic abdominal pain
  • Tobacco use
  • Illicit drug use

 

STAGES OF CHANGE

Precontemplation

Contemplation

Preparation

Action

Maintenance

Stages of Change Circle

Prochaska & DiClemente

 

Algorithm Card

 

BRIEF INTERVENTION

Brief Intervention Flow Chart

 

 

SIX COMMON ELEMENTS of
BRIEF INTERVENTIONS:

  • Feedback

  • Responsibility

  • Advice

  • Menu of Options

  • Empathy

  • Self-Confidence

 

 

BRIEF INTERVENTION

Men: > 3-4 drinks per occasion
> 15 drinks per week
Women: > 2-3 drinks per occasion
> 10 drinks per week

or
> 2 Yes on CAGE questions

 

Information to Teach Patients
on ETOH:

  • Abnormal labs (GGT, MCV) may be from etoh

  • Tolerance bad, means "alarm not going off"

  • Link between presenting problems & etoh

  • How much alcohol is in one standard drink

  • BAC charts for male/female X body weight

 

 

ADVISE a Plan of Action 
for At-Risk Drinkers:

  • Recommend a consumption limit based on health risks

  • Ask the patient to set a low-risk drinking goal

  • Provide patient education materials

 

KNOW YOUR PERSONAL LIMIT:

ONE DRINK

= One bottle of beer (12 oz.)
= One glass of wine (6 oz.)
= One "single" drink (1 oz. of liquor)
NUMBER of DRINKS PER HOURS  100 lbs 120 lbs 140 lbs 160 lbs 180 lbs 200 lbs 220 lbs 240 lbs
M / F M / F M / F M / F M / F M / F M / F M / F
1 drink in 1 hour .02/.03 .02/.02 .01/.02 .01/.01 .00/.01 .00/.01 .00/.00 .00/.00
1 drink in 2 hours .01/.02 .00/.01 .00/.00 .00/.00 .00/.00 .00/.00 .00/.00 .00/.00
1 drink in 3 hours .00/.01 .00/.00 .00/.00 .00/.00 .00/.00 .00/.00 .00/.00 .00/.00
2 drinks in 2 hours .03/.04 .03/.04 .02/.03 .01/.02 .01/.02 .00/.01 .00/.00 .00/.00
2 drinks in 3 hours .02/.03 .01/.03 .00/.01 .00/.01 .00/.00 .00/.00 .00/.00 .00/.00
2 drinks in 1 hour .06/.07 .05/.06 .04/.05 .03/.04 .03/.03 .02/.03 .02/.02 .02/.02
3 drinks in 3 hours .06/.09 .05/.06 .03/.05 .02/.03 .01/.03 .01/.02 .00/.01 .00/.01
3 drinks in 2 hours .08/.10 .07/.09 .05/.06 .04/.05 .03/.04 .02/.03 .02/.03 .01/.02
4 drinks in 4 hours .09/.11 .06/.08 .04/.06 .03/.05 .02/.03 .01/.02 .00/.02 .00/.01
4 drinks in 3 hours .10/.13 .08/.10 .06/.08 .05/.06 .03/.05 .03/.04 .02/.03 .01/.03
5 drinks in 5 hours .11/.14 .08/.11 .05/.08 .04/.06 .02/.04 .01/.03 .00/.02 .00/.00
3 drinks in 1 hours .10/.12 .08/.10 .07/.08 .06/.07 .05/.06 .04/.05 .04/.05 .03/.04
5 drinks in 4 hours .13/.16 .09/.12 .09/.10 .05/.07 .04/.06 .03/.05 .02/.04 .01/.03
4 drinks in 2 hours .12/.15 .09/.12 .08/.10 .06/.08 .05/.07 .04/.06 .04/.05 .03/.04
5 drinks in 3 hours .14/.18 .11/.14 .09/.11 .07/.09 .06/.08 .05/.06 .04/.05 .03/.04
5 drink in 2 hours .16/.19 .13/.16 .10/.13 .09/.11 .07/.09 .06/.08 .05/.07 .05/.06

 

LOW RISK DRINKING GUIDELINES:

Men: 3 drinks per day, max, and 14 drinks per week, max.
Women: 2 drinks per day, max, and 9 drinks per week, max.


NO AMOUNT OF ALCOHOL IS SAFE IF YOU ARE DRIVING.
YOUR RISK OF CRASHING GOES UP, EVEN WITH VERY SMALL AMOUNTS.

NO AMOUNT IS SAFE IF YOU ARE PREGNANT OR TRYING TO GET PREGNANT

 

RECOMMENDED LIMITS
for At Risk Drinkers*

Men: 3-4 drinks/day and
14 drinks/week
Women: 2-3 drinks/day and
10 drinks/week

*Sanchez-Craig, Wilkinson, Phil, Davila (1995): AJPH, 85 (6) 823-828

 

RECOMMENDING ABSTINENCE:

Advise to abstain if:

  • Pregnant or trying to get pregnant

  • Taking meds that interact with alcohol

  • Contraindicated by medical conditions

  • Alcohol dependent

  • Want to find out if dependent