Tools for Intentional Living – Dr. J. Nickens

This post is being republished due to recent conversations I’ve had both in and outside of my office.

Do you drink alcohol?  If so, do you manage it easily and safely, or do you have a drinking problem? Social drinking (no more than 2 drinks a day for men and 1 drink a day for women) is widely practiced and accepted, and according to some researchers even may reduce the risk of coronary disease.  A “drink” should be considered as 12 ounces of beer, 5 ounces of wine or 1.5 ounces (one shot) of liquor. Many people however have a problem with alcohol that threatens their health, relationships and employment, and may endanger or distress other people.  Counting drinks on a daily basis may not give you a clear understanding of the impact of alcohol in your life or on others around you, so along with counting drinks a broader view is necessary.  Some signs of problems drinking include: Becoming moody or argumentative after drinking; Drinking more for the same effect; Drinking alone; Drinking to cope with issues such as loneliness, or discontent with ones partner or job; Drinking to ward  off depression or anxiety; Mishandling daily affairs or relationships; Forgetting events that occur while drinking; Discovering that former friends are staying away from you because of your drinking.

The Alcohol Use Disorders Indentification Test (AUDIT) was developed by the World Health Organiztion of provide a simple screening tool.  It can be used by anyone to help decide if you or someone you know might need a more thorough assessment for problem drinking.

To take the AUDIT  just answer each question with the honest number of 1, 2, 3 or 4 (**questions #9 and #10 can be scored only with a zero, a two or a four).  Remember, not being honest with yourself as you answer the questions may be a sign that you have a drinking problem you are afraid to face.

1.  How often do you have a drink containing alcohol? 0 (never)/1 (monthly or less)/2 (two to three times per month)/3 (two to three times per week)/ 4 (four or more times per week) 

2. How many drinks do you have on a typical day when you are drinking? 0 (none)/ 1 (one or two)/ 2 (three or four)/ 3 (five or six)/ 4 (seven to nine) ** Score 5 points if your response is ten or more drinks on a typical day.

3.How often do you have more than three drinks (women) or more than five drinks (men) on one occasion.  0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

4. How often during the last year have you found that you were unable to stop drinking once you had started? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

5. How often during the last year have you failed to do what was expected from you [not going to work or school, ignoring relationship, medical or legal expectations] because of drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

7. How often during the last year have you had a feeling of guilt or remorse [for your behavior or for drinking itself) after drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? 0 (never)/ 1 (less than monthly)/ 2 (monthly)/ 3 (weekly)/ 4 (daily or almost daily)

9. Have you or someone else been injured [intentional or not, self-inflicted or from another] as a result of your drinking [and/or while drinking]?  0 (never)/ (no score of “1″ -skip to score two)/2 (yes, but not in the last year)/ (no score of “3″- skip to score 4)/ 4 (yes, during the last year)

10. Has a relative, doctor or other health worker been concerned about your drinking or suggested you cut down? 0 (never)/ (no score of “1″ -skip to score two)/2 (yes, but not in the last year)/ (no score of “3″- skip to score 4)/ 4 (yes, during the last year)

Add up the numbers for the ten questions to get your score.  A score of 8 or more indicates possible problem drinking and the need for a more thorough assessment.  If your score indicates the need for an assessment, you should consult a qualified health provider to discuss your drinking and the possible treatments that are available to you.   If your total score is less than eight but more than four, it would be advisable to consider how you are using alcohol, and ask someone close to you if they believe you are a problem drinker.  If your score is less than four, you are probably using alcohol responsibly, and can simply be mindful of any changes in your use or in the results of your drinking.