Alcohol Abuse Symptoms

Twenty Questions About Alcohol Abuse

How to do a motivational interview
In the first interview, you begin to motivate persons to see the truth about their problem. Questions about alcohol and other drug use are most appropriately asked as a part of the history of personal habits, such as use of tobacco products and caffeine ingestion. Questions should be asked candidly and in a non-judgmental manner to avoid defensiveness. Remember, this is person-centered interviewing, not professional-centered, and the interview should incorporate the following elements (Prochaska, 2003; Delbanco, 1992; Graham. & Fleming, (1998): Miller & Rollnick, 1991; Ockene, Quirk, Goldberg, Kristeller, Donnelly, Kalan et al., 1998; Rollnick, Heather, Gold & Hall, 1992):

• The person should be alcohol-free at the time of the screening;
• Offer empathic, objective feedback of data;
• Work with ambivalence;
• Meet the person’s expectations;
• Assess the person’s readiness for change;
• Assess barriers and strengths significant to recovery efforts;
• Reinterpret the person’s experiences in light of the current problem;
• Negotiate a follow-up plan;
• Provide hope.

Questions to ask an ADULT
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed the following low-risk drinking guidelines:

• For men, drinking no more than two drinks a day and no more than four drinks on a single occasion.

• For women and persons over 65 years of age, drinking no more than one drink a day and no more than three drinks on a single occasion.
• Pregnant persons and those with medical problems complicated by alcohol use should abstain completely (NIAAA, 1995).

At sometime during the first interview, certain questions need to be asked to assess alcohol problems. They have to be answered honestly to give you a clear picture of the extent of the drinking. Most persons who have alcohol problems will be evasive or deny their alcohol abuse, so the questions should be asked of the person, as well as a reliable family member.
The following questions and flags are taken from the American Society of Addiction Medicine (https://www.asam.org):
1. Have you ever tried to cut down on your drinking?
2. Have you ever felt annoyed when someone talked to you about your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have you ever had a drink in the morning to settle yourself down?
5. Has alcohol or drugs ever caused you family problems?
6. Has a physician ever told you to cut down on or quit use of alcohol?
7. When drinking/using drugs, have you ever had a memory loss (blackout)?
If persons answer yes to any one of these questions that’s a red flag for alcoholism. If they answer yes to two questions, that’s probable alcoholism. Make sure you don’t just ask the person. Ask family members, friends and anyone else who can give you collateral information.

History/Behavioral Observation Red Flags for Adult Alcohol Abuse

• Tremor/perspiring/tachycardia.
• Evidence of current intoxication.
• Prescription drug seeking behavior.
• Frequent falls; unexplained bruises.
• Diabetes, elevated BP, ulcers non-responsive to treatment.
• Frequent hospitalizations.
• Gunshot/knife wound.
• Suicide talk/attempt; depression.
• Pregnancy (screen all).

Laboratory Red Flags for Adult Alcohol/Drug Abuse

• MCV-over 95
• MCH-High
• GGT-High
• SGOT-High
• Bilirubin-High
• Triglycerides-High
• Anemia
• Positive UA for alcohol

History/Behavioral Observation Red Flags for Adolescent Alcohol Abuse

• Physical injuries; MVA, gunshot/knife wound, unexplained or repeated injuries.
  • Evidence of current use, e.g. dilated/pinpoint pupils, tremors, perspiring,

  tachycardia, slurred/rapid speech.

  • Persistent cough (cigarette smoking is a risk factor).
  • Engages in risky behavior, e.g. unprotected sex.
  • Marked fall in academic/extracurricular performance.
  • Suicide talk/attempt; depression.
  • Sexually transmitted diseases.
  • Staphylococcus infection on face, arms, legs.
  • Unexplained weight loss.
  • Pregnancy (screen all).

  Laboratory Red Flags for Adolescent Alcohol/Drug Abuse

  • Positive UA for alcohol/illicit drugs
  • Hepatitis A-B-C
  • GGT-High
  • SGOT-High
  • Bilirubin-High

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