Screening questions

I just made a post that triggered a few thoughts.  As an ex substance abuse counselor I am very frustrated with some of the screening questions that are still in common use … and should only be applied after a good deal of thought.    

1. Do you regard your use of alcohol as normal?   Well, if I don’t alcohol drink at all, I guess I am not normal.  But if I answer no, then I have just hit a trigger. Or, let’s say I have one drink a week, but I like to add  hot sauce to it …that isn’t normal.

2.  Do you drink before noon?  If I work the night shift and get off at 7 am, then I have a drink after work… Well, it looks like another trigger.  I  guess I need to wait until I get some sleep. Then I can wake up and have a drink in my morning at 3 pm, and it will be OK.

3.  Have your relatives ever complained about your drinking.  I do have a pill popping relative who is always wanting me to take uppers instead of drinking coffee. So, yes,  a relative has complained.

4.  Have you ever attended an AA meeting?  Interesting.  All substance abuse counselors I know were required to attend an AA meeting as a part of their training.  So, I guess all of those counselors hit that trigger as well.

There are many more such questions, but you get the point. As with many tools that are in use, I don’t have a problem with the tool.  I do often have a problem with the way they get used.   I used to see so many of these questions blindly applied without any clarifying questions.

Surveys are also notorious for having questions like that. It is always a balance to have questions that are specific enough to get the information you need, but open enough to get clarification on perfectly "normal" edge cases.

As a medical and social outlier, I HATE questions like that. I tend to explain my answer to the person (answers like you said about working night shift) and they just look at me, and put down something that doesn't relate to reality at all, but is on their answer sheet.

I'm weird, my life is weird, and my health is weird. And it's not something that questions like that relate to.

I had a therapist say "do this workbook, let's see if it helps!" I did. I answered every single question. None of my answers fit what the book (and her) were expecting, although I think it showed up some stuff that should have been seriously considered as affecting me. But it didn't fit her expectations. She said "Oh." and ignored it. I quit going to her, as she obviously has as agenda that isn't the same as mine. Mine was to actually figure out what was going on.

Here, alcoholic is now defined as at least one drink alone per week, three or more social drinks per week, or drinking excess in a single setting (passing out, vomit, memory loss) at least 10 times per year.

In five years we went from one of the top alcohol consumers in the world (canada always made the top 10 per capita) to having dramatic effect on the economy as brewery after brewery close.  Considering local to me, these breweries used to have to use a big chunk of local grown ingredients,  farmers are feeling the effects big time.

I know first hand the negative effects of life with an alcoholic,  but one drink per week does not cause that life shattering deviation.   Our new definition has gone haywire.

Sorry, I couldn't resist.

I don’t drink a great deal, but I do drink quality stuff …such as 18 year Elijah Craig.   I want my taste buds to enjoy it. That means not having other people around.   I still have too much of the CEO in me.  When I am around others, I ginger ale.  I want to be stone sober…able to hear …and able to know what I am saying.

Hi Pearl,

To use a distinction I often use, it sounds as if the therapist had a job and not a career.  

Hi r,

It would seem that almost every accreditation surveyor I have worked with is an alcoholic per the definition you quote.   Surveys were generally 3 days.   And, surveyors often had 3 drinks each night.  My personal guideline was 2 drinks if I was driving and 3 if I wasn’t.    Given my size, at 3  Manhattans I would be well below a BAL of 0.08.   So, according to what you have provided, a person might never be drunk but be an alcoholic.  That is kind of like getting a speeding ticket on an American interstate even though the governor on your car is set at 55.

I do find limited merit to the definition though.  I can think of one person who checked themselves into rehab even though they only had 2 drinks every night when they got home from work.  Their concern was they found out they HAD to have those two drinks.

I hate that type of survey, too.  I've never taken one about alcohol, but others, including at the doctor's office, or the social security office, can have some very ambiguous questions.  If there's room (and it's a paper survey) I'll try to make explanatory notes, but I don't know if anyone pays attention to those.  There was one I had to fill out recently (can't remember where) that wanted to know my nationality -- European, African, Asian, etc.   I wrote in American, which wasn't even on the list of possibilities!  I think they were after race (there is only one race, human), but why they would expect someone whose ancestors have been in North America for four hundred years to identify as European, no matter what their skin color is, I will never understand!