Alcohol-Related Harm

The clinician should assess the range of problems the patient has encountered as a result of their drinking. In addition to physical and mental health, the patient’s drinking may have led to family problems, detrimentally affected work performance, social relations or financial stability. Alcohol-related offences such as drink–driving are also relevant. A specific crisis in one of these areas may have been the impetus for seeking help, and this should be explored. 

Discussion of the ‘less good things’ about drinking can enhance the patient’s readiness for change (see Chapter 6 Brief interventions – In person). Alcohol harms are usually assessed using unstructured clinical interviewing. The Alcohol Problems Questionnaire (APQ) is a reliable instrument that covers eight domains – friends, money, police, physical, affective, marital, children and work.