Asking the Person About Their Alcohol Consumption (Quantity–Frequency Estimates)

A quantitative alcohol history can be a reliable method of detecting risky patterns of alcohol consumption. Such a history comprises: 

• • • the daily average consumption (grams per day or standard drinks per day) of alcohol 

    • the number of drinking days per week (or month). 

Where use exceeds that recommended in the NHMRC guidelines, a more detailed assessment is indicated to exclude harmful use and/or dependence. 

The quantity-frequency approach has been adopted in the US for screening. It is also the basis for using the first three questions in the AUDIT questionnaire (the AUDIT-C, below).  

The health professional’s interviewing style is important, and includes: 

• • • taking a non-judgmental approach which normalises alcohol use (for example, asking about a range of lifestyle factors including nutrition, tobacco use, caffeine intake, alcohol use) 

    • taking a ‘top down’ approach (for example, suggesting a level of drinking that is higher than expected so the patient is more likely to feel comfortable admitting the real level of drinking by bringing the estimation down to the correct level). 

It is important to carefully interpret language. For example, if a patient reports ‘a drink’, this might mean one standard drink or a night of heavy drinking. Quantitative measures should replace non-specific terms, such as a ‘social drink’.