The two-question test for alcohol abuse

The NHS Choices website has reported that a simple two-question test for alcohol misuse may be an effective way to identify those at risk.

Rather than asking patients how many units they drink each week, as doctors are aware that most patients underestimate or deliberately lie, doctors may start asking two simple questions.

The first question is: “Do you regularly have more than six drinks in one sitting?” This question will provide an indication of regular binge drinking; six drinks can be anywhere from nine to 18 units of alcohol, depending on the type and size of the drink.

The second question is: “Do you regret a drunken escapade that took place in the past year?” Again, this will indicate if a person is drinking excessively on a regular basis to the point that they cannot control their own behaviour.

Answering ‘yes’ to just one of these questions does not indicate a problem, although this does not mean that there is not a problem, but anybody who answers ‘yes’ to both questions is likely to have a drink problem. The results of the study showed that these two questions correctly identified an individual with a drinking problem in 87.2% of cases.

This new approach is the result of a review of past studies into behaviour and alcohol consumption to determine if short and quick screening approaches are an effective way for GPs to identify those who may require some counselling.

The research was carried out by Leicester General Hospital and the report was published in British Journal of General Practice.

Any patient who answers ‘yes’ to both questions should then be asked to complete a longer questionnaire that can more accurately determine if they have a problem.

The NHS Choices website also explain in some detail the limitations and problems with this approach to alcohol screening and that the researchers make “a cautious recommendation for one or two verbal questions as a screening test for alcohol-use disorder in primary care, but only when paired with a longer screening tool to decide who warrants a brief alcohol intervention.”

Most people who have an alcohol problem are well aware of it, and often GPs just need to ask some straightforward questions to get people to open up and start talking. It also makes a lot of sense to ask people about the number of drinks they have and what their behaviour is like rather than asking them how many units of alcohol they consume in an average week.