Alcohol counselling

Question 1

Alcohol consumption

Answer 1

• what do you drink?
• how much do you drink?
• how often do you drink?
• how long have you been drinking?

Question 2

CAGE

Answer 2

C - tried or thought about cutting down
A - annoyed when asked about alcohol
G - guilty about drinking
E - eye-opener (when waking up)

Question 3

DWT

Answer 3

D - dependency - can they do ADLs without alcohol
W - withdrawal - what happens when they don’t drink
T - tolerance - need more alcohol to feel the effects

Question 4

MISH

Answer 4

M - mood - depression? 1-10 score
I - insight - do they think their drinking is excessive
S - self-harm, suicide
H - hallucinations?

Question 5

FAM

Answer 5

F - family, friends, forensics, finances - drinking with people? safe to work?
A - addictions - alcohol, drugs
M - medical conditions and medications

Question 6

Support for patient

Answer 6

• Alcoholics Anonymous
• friends and family
• community alcohol team

Question 7

Medical management - alcohol withdrawal

Answer 7

• chlordiazepoxide - usually 1 week in community
• disulfiram - unpleasant response when drinking (severe reaction)
• consider vitamin B1 (thiamine) replacement

Question 8

FRAMES

Answer 8

F - feedback that high risk
R - responsibility to make a change
A - advice, can have support
M - menu for change - options
E - empathy
S - self-efficacy - you can do it