Step III: Advise Appropriate Action

State Your Medical Concern

Be specific about your patient's drinking patterns and related health risks.
ASK: How do you feel about your drinking?

Advise to abstain or cut down

Advise to abstain if:
-- evidence of alcohol dependence
-- history of repeated failed attempts to cut down
-- pregnant or trying to conceive
-- contraindicated medical condition or medication

Advise to cut down if:
-- drinking above recommended low-risk drinking amounts and no evidence of alcohol dependence 

Agree upon a plan of action:

 ASK: Are you ready to try to cut down or abstain?

Talk with patients who are ready to make a change in their drinking about a specific plan of action.

 For patients who are not alcohol dependent:

-- Recommend low-risk consumption limits for your patient based upon the low-risk drinking recommendations and your patient's health history (See Recommendations to patients for low-risk drinking).
-- Ask your patient to set a specific drinking goal:
Are you ready to set a drinking goal? Some patients choose to abstain for a period of time or for good; others prefer to limit the amount they drink. What do you think will work best for you?
-- Provide patient education materials and tell your patient:
It helps to think about your reasons for wanting to cut down and examine what situations trigger unhealthy drinking patterns. These materials will give you some useful tips on how to maintain your drinking goal.

 For patients with evidence of alcohol dependence:

Refer for additional diagnostic evaluation or treatment.
Procedures for patient referral are as follows:
-- Involve your patient in making referral decisions.
-- Discuss available alcohol treatment services.
-- Schedule a referral appointment while the patient is in the office.

 Some Patient Counseling Tips

Use an empathic, nonconfrontational style.
Offer your patient some choices about how to effect change.
Emphasize your patient's responsibility for changing drinking behavior.
Convey confidence in your patient's ability to change drinking behavior.

 

When discussing your patient's alcohol-related problem with them, it is best to emphasize their responsibility for changing their drinking behavior. True False

 

toc | return to top | previous page | next page