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drtrishulreddy
02-01-2011, 08:13 AM
RECOMMENDATIONS:

CAGE Questions should be asked in those patients who currently drink more than moderation. Moderate drinking is defined as follows:

* Men -- no more than two drinks per day
* Women -- no more than one drink per day
* Over 65 -- no more than one drink per day

Note: A standard drink is l2 grams of pure alcohol, which is equal to one l2-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or l.5 ounces of distilled spirits.


Advise patients to abstain from alcohol under certain conditions:

* when pregnant or considering pregnancy
* when taking a medication that interacts with alcohol
* if alcohol dependent
* if a contraindicated medical condition is present (e.g., ulcer, liver disease)


If a patient is at risk for coronary heart disease, discuss the potential benefits and risks of alcohol use:

Light to moderate drinking is associated with lower rates of coronary heart disease in certain populations (e.g., men over 45, postmenopausal women). Infrequent or nondrinkers are not advised to begin a regimen of light to moderate drinking to reduce the risk of coronary heart disease because vulnerability to alcohol-related problems cannot always be predicted. Similar protective effects can likely be achieved through proper diet and exercise.


REMEMBER!

Ask all patients:

* Do you drink alcohol, including beer, wine, or distilled spirits?


Ask current drinkers about alcohol consumption:

* On average, how many days per week do you drink alcohol?
* On a typical day when you drink, how many drinks do you have?
* What is the maximum number of drinks you had on any given occasion during the last
month?


Ask current drinkers the CAGE questions:

* Have you ever felt that you should Cut down on your drinking?
* Have people Annoyed you by criticizing your drinking?
* Have you ever felt bad or Guilty about your drinking?
* Have you ever had a drink first thing in the morning to steady your nerves or get rid of a
hangover (Eye opener)?




COUNSELING TIPS

* Use an empathic, nonconfrontational style.
* Offer your patient some choices about how to effect change.
* Emphasize your patient's responsibility for changing drinking behavior.
* Convey confidence in your patient's ability to change drinking behavior.

WHAT TO DO IF SP DOES NOT AGREE TO CHANGE HIS BEHAVIOR AFTER COUNSELING?

Do not be discouraged if patients are not ready to take action immediately. Decisions to change behavior often involve fluctuating motivation and feelings of ambivalence..

* Restate your concern for your patient's health.
* Reinforce your willingness to help when the patient is ready.



Best,

Trishul Reddy M.D.







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