• Primary care has a crucial role in the detection, assessment and treatment of individuals with alcohol problems. • 1 in 5 attendees at a GP surgery are drinking in a hazardous way. • 1 in 25 have alcohol dependence. • Majority of them associated with drinking is related to episodes of heavy drinking in a hazardous manner. Definitions Hazardous Drinking Male drinking> 21 units per week (> 4units per day). Female drinking> 14 units per week (> 3 units per day). Harmful Drinking Drinking that can cause physical, psychological or social harm to an individual. Alcohol Dependence >3 of tolerance, withdrawals, craving, persistent harmful use, preoccupation, inability to control. Units Of Alcohol • 1/2 pint beer, glass of wine -1 unit. • Bottle of spirits -30 - 40 units. • 440ml can strong (9%) lager/cider -4 units. • Bottle of wine -8 - 10 units. CAGE Assessment Have you ever felt you ought to Cut down on your drinking? Have people Annoyed you by criticising 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? (‘Eye opener’) A Score > 1 is a positive screen and indicates further assessment required. Assessment/Detection > Maintain high index of suspicion and asking about alcohol as part of routine assessment. > Estimate daily and weekly drinking amounts in units. > Screening instruments, CAGE, AUDIT. > MCV raised60% heavy drinkers. > GGT raised80% heavy drinkers. Back Next Page Flowchart