How to Assess Drug & Alcohol Use

How to Assess Drug and Alcohol Use

Summary

  • GPs and other health professionals may use specialist tools such as a symptom checklist or questionnaire to assess and identify someone's addiction
  • Drinking and drug diaries are used by individuals to reflect and track their own drug and alcohol use, this involves documenting how much they use and how they felt
  • Education on drug, alcohol and addiction topics is useful in self-reflecting on an individual's own use. Understanding what alcohol "units" are and how many are in different drinks can help an individual understand their own drinking behaviours

How do Health Professionals Assess Drink or Drug Use and Addiction?

When GPs or health professionals wish to assess a person’s drinking or drug use, one of the tools they use is the DSM-5’s criteria for addiction.


The Diagnostic and Statistical Manual of Mental Disorders version 5 (known as the DSM-5), is a guidebook used by medical and mental health professionals in order to classify various disorders and conditions, such as addiction.


The latest version (the DSM-5) consists of 11 criteria, used to assess whether a person has an addiction and how severe it is. The 11 criteria for addiction are:


  1. Using drugs or alcohol for longer and in larger amounts than intended
  2. Unsuccessful attempts to quit or cut down
  3. Spending excessive amounts of time getting hold of, using, or recovering from the drug or alcohol
  4. An intense desire and craving for the drug or alcohol.
  5. Not managing to do what you should at home, work, or school because of drug or alcohol use
  6. Continued use of the drug or alcohol despite problems cause in relationships with others
  7. Giving up important social, occupational or recreational activities because of drug or alcohol use
  8. Continued use of the drug or alcohol in situations where it could be dangerous
  9. Continued use of the drug or alcohol even if you have a physical or psychological problem that could have been caused or made worse by the drug or alcohol
  10. Requiring greater amounts of the drug or alcohol in order to get the desired effect
  11. Development of physical withdrawal symptoms, which can be relieved by using the drug or alcohol.

According to the DSM-5, if a person is experiencing 2-3 of these criteria they have a mild addiction, 4-5 criteria experienced is a moderate addiction, and 6 or more criteria experienced is a severe addiction.


A GP or health professional may use the 11 criteria to assess a person’s addiction. This may be done through conversation or through a questionnaire for the person to answer. However, they may instead decide to use another checklist, one that focuses on a particular drug or specifically on alcohol.

For example, the Alcohol use disorder identification test (AUDIT).


This questionnaire is used to specifically asses alcohol use and potential related problems.


The full questionnaire can be found at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684823/Alcohol_use_disorders_identification_test__AUDIT_.pdf

Addiction is complex and there are no fast and hard rules to assess whether someone is addicted or not. These checklists, questionnaires and criteria are used as a guideline to try and identify as best as possible whether someone may need some help or support.


While these tools can help guide an assessment, if someone feels they need help or support with drugs or alcohol, they should speak to a health professional or GP despite how they score on a questionnaire.

How Can People Track and Assess Their Own Drug and Alcohol Use?

It can be difficult for people to think about their own drug or alcohol use.


However, it is important for everyone to consider their drug or alcohol use. This is because often people who have a problem with alcohol or drugs are unaware themselves.


Tracking and assessing personal drug or alcohol use can help to identify when help or support is needed.


Assessing drug or alcohol use is done through self-reflection. There are some techniques to help with this self-reflection, namely through the use of diaries and education on drug and alcohol topics.

Drinking and Drug Diaries

Drinking and drug diaries are a simple way to assess and track personal drug and alcohol use.


They work by getting a person to write down how often they drink or use drugs and the emotions that went with it.


By writing down their use, there is clear and irrefutable documentation on the frequency of the individual's drinking or drug use. This helps someone more accurately track their use, as people's memories are not always reliable and they may be underestimating their use of alcohol or drugs.


By writing down their feelings, drinking and drug diaries encourage individuals to think about their drink and drug use in a more meaningful way. 

There are many drinking and drug diaries available to use. In fact, a template is not necessarily needed, as they can be easily created with a pen and paper or on a computer.


Below are some links to drinking and drug diaries.


Drinking Diaries:

https://www.drinkaware.co.uk/tools/mydrinkaware-app

https://smartcjs.org.uk/wp-content/uploads/2020/07/Drinking-Diary.pdf

http://wellbeing.turning-point.co.uk/wp-content/uploads/sites/4/2015/10/Drink_Diary1.pdf



Drug Diaries:

https://www.smartcjs.org.uk/wp-content/uploads/2015/07/Drug-Use-Diary.pdf

https://www.getselfhelp.co.uk/docs/SubstanceUseDiary.pdf

Alcohol and Drug Education

Education about alcohol and drug topics, including addiction are important in fully understanding drug and alcohol use.


In fact, many GPs or health professionals provide information on alcohol, drugs and addiction for their clients and even involve the information in support or treatment. Being better informed on topics such as how drugs work or what addiction is can help someone better understand their own drug or alcohol use or recognise problems in themselves or others.


Understanding how much alcohol is in our drinks is also important. In the UK there are recommendations on how many "units" of alcohol should be consumed in a week.


A "unit" is simply a measure of how much pure alcohol is in something and it is recommended that adults are advised not to drink more than 14 units a week on a regular basis. This is because excessive alcohol consumption can lead to health complications.


However, it can be tricky to know how many units of alcohol are in a drink. Diagrams have been created to easily show how many units are in each drink, such as the one created by Cancer research UK.


Additionally, Alcohol Change UK and Drink Aware provide simple tools to calculate units:


https://www.drinkaware.co.uk/facts/alcoholic-drinks-and-units/what-is-an-alcohol-unit


https://alcoholchange.org.uk/alcohol-facts/interactive-tools/unit-calculator

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