Alcohol Abuse History

  • Alcohol intake Hx:
    • What type of alcohol?
    • When did you first start? How old were you? When did you notice your alcohol intake starting to increase? When was the last time you consumed alcohol?
    • How much\many?
    • How frequent? Social? Episodes of binging? Specific time of the day?
    • Do you use any medications\drugs in combination w\ alcohol? Smoking?
    • Have you ever tried to stop drinking? If not, do you want\feel ready to stop?
  • RAFFT:
    • Do you drink alcohol to Relax, feel better about yourself?
    • Do you drink alcohol while you’re Alone?
    • Do you Forget things you did while intoxicated?
    • Do your Family\Friends tell you that you should cut down?
    • Have you ever gotten in Trouble while intoxicated?
  • CAGE:
    • Have you ever felt you should Cut down on your drinking?
    • Have people Annoyed you by criticizing your drinking?
    • Have you ever felt Guilty about your drinking?
    • Have you ever felt you need a drink first thing in the morning (Eye-opener)?
  • Medical Hx:
    • Dependence Sx: if you stop drinking do you feel N\V, shakes, headaches, seizures
    • Co-morbidities: DM, HTN, DLP, heart ds
    • Poisoning: problems in the eyes, kidneys, liver ds (jaundice)
    • Do you take any medications? OTC drugs? Recreational drugs?
    • Ever been hospitalized for drinking-related injuries\illnesses?
    • Allergies
    • Family Hx of problems w\ drinking, mental illness?
  • Psych Hx:
    • Screen for: depression, bipolar, anxiety, psychosis (full symptoms, check suicide assessment file)
    • Harm towards self or others, suicide risk
  • Social Hx:
    • How is your relationship w\ your family and friends?
    • Marital status? Children?
    • Occupation? Satisfied\secured?
    • Stressors? (Emotional, financial)
    • Have you ever been exposed to social trauma? (Loss of a loved one, violence, abuse)


Download the PDF version: here

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