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Low-risk drinking limits Categories of drinking Drinks per week Drinks per day 14 4 IV Dependent: 5% Harmful: 8% III Men Women 7 3 II All age >65 7 3 I 5 oz. glass of wine 12 oz. beer Risky: 9% Low risk or Abstain: 78% 1.5 oz (shot) of liquor Risks of unhealthy drinking Depression. Anxiety. Aggressive behavior. Alcohol dependence. Insomnia. Memory loss. Cancer of the throat and mouth. Premature aging. Hypertension. Heart failure. Anemia. Blood clotting. Breast cancer. Frequent colds, reduced resistance to infection, increased risk of pneumonia Vitamin deficiency. Bleeding. Stomach inflammation. Diarrhea. Malnutrition. Liver damage. Inflammation of the pancreas. Men: Erectile dysfunction. Women: Risk of deformed, developmentally delayed, or low birth weight babies. Impaired sensation leading to falls. Failure to fulfill obligations at work, school, or home. Car accidents. Legal problems. Painful nerves. Numb, tingling toes. Readiness ruler Not at all 0 1 2 3 4 5 6 7 8 9 10 Very Screening, Brief Intervention Referral to Treatment Steps of the Brief Intervention Raise the subject • “If it’s okay with you, let’s take a minute to talk about the annual Provide feedback • “As your doctor, I can tell you that drinking (drug use) at this level can be harmful to your health and possibly contributing to the health problem you came in with today.” screening form you’ve filled out today.” Enhance motivation • “On a scale of 0-10, how ready are you to cut back? Negotiate plan • “What steps can you take to cut back your use? • If >0: “Why that number and not a ____ (lower one)?” • If 0: “Have you ever done anything while drinking (using drugs) that you later regretted?” • “How would your drinking (drug use) have to impact your life in order for you to start thinking about cutting back?” Referral: SAMHSA Treatment Center Locator AUDIT/DAST score Zone AUDIT: 20+ DAST: 6+ IV – Dependent AUDIT: 16–19 DAST: 3–5 III – Harmful AUDIT: 8–15 DAST: 1–2 II – Risky AUDIT: 0–7 DAST: 0 I – Low risk http://findtreatment.samhsa.gov/