Patients with this result are at high risk for adverse outcomes related to alcohol use and are highly likely to meet DSM-5 criteria for an Alcohol Use Disorder.
Alcohol Use Resources
- NIAAA: Helping Patients Who Drink Too Much: A Clinician's Guide
- SAMHSA: Medication for the Treatment of Alcohol Use Disorder
- AAFP: Outpatient Management of Alcohol Withdrawal Syndrome
- NIAAA: Introduction to Alcohol Withdrawal
- U.S. Preventive Services Task Force: Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care
- NIAAA: Harmful Interactions With Alcohol
- Yale School of Medicine: Screening, Brief Intervention & Referral to Treatment Training Manual
- NIDA: Motivational Interviewing Skills Practice
- Center for Health Training: OARS Essential Communication Techniques
- SAMHSA: Behavioral Health Treatment Services Locator
- NIDA: Principles of Drug Addiction Treatment: A Research-Based Guide (3rd ed.)
The suggested intervention for this risk level is to confirm diagnosis through a clinical interview using the DSM-5 Alcohol Use Disorder criteria as a guide.
- Express concern and recommend cessation;
- Use the FRAMES components and motivational interviewing techniques (see references for specific resources) to encourage engagement in treatment.
- Consider prescribing medications to treat moderate to severe alcohol use disorder. The U.S. Food and Drug Administration (FDA) has approved three medications for treating alcohol dependence: Naltrexone, Acamprosate, and Disulfiram.
- Make a specific plan, including strategies for reducing the health consequences of alcohol use.
- For patients who are ready to quit, assess risk for withdrawal, and link to detox as indicated.
- Provide on-site counseling or a referral for off-site counseling and/or support group to complement medication treatment.
- Assess and manage any co-occurring problems, such as pain and depression, that may be impacting alcohol use.
- Review any prescribed medications to identify those that when combined with alcohol may increase the risk of overdose (opioids, benzodiazepines).
- Educate patient on risks associated with combining alcohol with other drugs.
- Advise not to use alcohol and drive.
- Arrange follow-up.