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Alcohol Misuse Screening & Counseling

Alcohol Misuse Screening & Counseling

Unhealthy alcohol use includes a spectrum of behaviors, from risky drinking to alcohol use disorder. “Risky” or” hazardous” alcohol generally means drinking more than the recommended daily, weekly, or per-occasion amounts, resulting in increased risk for health consequences but not meeting criteria for alcohol use disorder. Risky use may be defined as exceeding the recommended limits of:

  • 4 drinks per day or 14 drinks per week for healthy adult men aged 21 to 64 years
  • 3 drinks per day or 7 drinks per week for all adult women of any age and men 65 years or older
  • Any alcohol consumption for pregnant women

Binge drinking is defined as a blood alcohol level of 0.08, which generally means:

  • 5 drinks in two hours for healthy adult men
  • 4 drinks in two hours for health adult women

People that drink so much that their bodies become dependent may have alcohol use disorder. They may lose their family, their job, their home and are at greater risk for health problems.

Calculators - interactive

Who is at risk

You may be at a greater risk for alcohol use disorder if you:

  • Have a parent with alcohol use disorder
  • Have a mental health problem, such as depression, anxiety, or schizophrenia
  • Are a young adult experiencing peer pressure
  • Have low self-esteem
  • Experience a high level of stress
  • Live in a family or culture where alcohol use is common and accepted
  • Have a close relative with alcohol use disorder

Symptoms

People with alcohol use disorder may engage in the following behaviors:

  • Drinking alone
  • Drinking more to feel the effects of alcohol (having a high tolerance)
  • Becoming violent or angry when asked about their drinking habits
  • Not eating or eating poorly
  • Neglecting personal hygiene
  • Missing work or school because of drinking
  • Being unable to control alcohol intake
  • Making excuses to drink
  • Continuing to drink even when legal, social, or economic problems develop
  • Giving up important social, occupational, or recreational activities because of alcohol use

People with alcohol use disorder may also experience the following physical symptoms:

  • Alcohol cravings
  • Withdrawal symptoms when not drinking, including shaking, nausea, and vomiting
  • Tremors (involuntary shaking) the morning after drinking
  • Lapses in memory (blacking out) after a night of drinking
  • Illnesses, such as alcoholic ketoacidosis (includes dehydration-type symptoms) or cirrhosis

What you can do

Seek help if you think you may have a problem. Talk to your doctor.

Preventive service at no cost

Adults 18 years or older, including pregnant women

The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use.

Medicare

Medicare recommends screening by a primary care physician to alcohol misuse and providing 4 brief face-to-face counseling sessions each year (if competent and alert during counseling).

Why screening is important

Excessive alcohol use is one of the most common causes of premature mortality in the United States, caused by both acute conditions (e.g., injuries from motor vehicle collisions) and chronic conditions (e.g., alcoholic liver disease). Alcohol use disorder can also lead to other health complications, including:

  • Bleeding in the gastrointestinal (GI) tract
  • Damage to brain cells
  • Cancer in the GI tract
  • Dementia
  • Depression
  • High blood pressure
  • Pancreatitis (inflammation of the pancreas)
  • Nerve damage
  • Changes in mental status, including Wernicke-Korsakoff syndrome (a brain disease that causes symptoms such as confusion, vision changes, or memory loss)

Alcohol use during pregnancy is also one of the major preventable causes of birth defects and developmental disabilities.

How Alcohol Affects Health

What the screening is

The screening only takes 1 to 2 minutes. You will be asked a few questions. If you screen positive, you should follow-up with a more in-depth risk assessment to confirm unhealthy alcohol use and determine the next steps of care.

Behavioral counseling interventions for unhealthy alcohol use vary in their specific components, administration, length, and number of interactions. Your doctor will guide you.

Treatment

In addition to the preventive service, GlobalHealth covers substance abuse treatment and counseling. Treatment may occur in stages and can include the following:

  • Detoxification or withdrawal to rid your body of alcohol
  • Rehabilitation to learn new coping skills and behaviors
  • Counseling to address emotional problems that may cause you to drink
  • Medical treatment for health problems associated with alcohol use disorder
  • Medications to help control addiction - Click here to see your Drug Formulary

See your member materials for coverage details.

National Helpline

Additional Tips

  • Use other cognitive behavioral strategies, such as drinking diaries, action plans, alcohol use “prescriptions,” stress management, or problem solving - talk to your doctor
  • Join a support group

Additional Resources