Location:
Name: ID:
1. YOUR DRINKING
Number of standard
"drinks" per week: drinks
Your drinking relative to American adults (same sex): percentile
2. LEVEL OF INTOXICATION
Estimated Blood Alcohol Concentration
(BAC) peaks:
in a typical week: mg
on a heavier day of drinking: mg
3. RISK FACTORS
Tolerance Level:
Low (0 -60) Medium (61 -120) High (121-180) Very High (181 +)
Other Drug Risk:
Low Medium High
Family Risk:
Low: 0 - 1 Medium: 2 - 3 High: 4 - 6 Very High: 7 +
MacAndrew Sore:
Normal Range: 0 - 23 Medium Risk: 24 - 29 High Risk: 30 +
Age at onset: years
Under 25 - Higher Risk 25 - 39 Medium Risk40 + Lower Risk
4. NEGATIVE
CONSEQUENCES
Severity of Problems
Low Medium High Very High
AUDIT 0-7 8-15 16-25 26-40
Your Score:
DRINC: Ever happened Low Medium High Very High
55-60 61 -75 76-90 91+
Your Score:
(Additional information on attached sheet.)
5. BLOOD TESTS
SGOT (AST): Normal range: 5 - 35
GGTP (GGT): Normal range: 0 - 30 Low Normal 31
- 50 High Normal
51 + Elevated I Abnormal
SGPT (ALT): Normal range: 7 - 56
Uric Acid: Normal range: 2.6 - 5.6
Bilirubin: Normal range: .2 - 1.2
6. NEUROPSYCHOLOGICAL TESTS
Well
Well
Above
Above Below Below
Average
Average Average Average Average
SV
1 2 3 4 5
TMTA 1 2 3 4 5
TMTB 1 2 3 4 5
SYDM 1 2 3 4 5
SHVA 1 2 3 4 5
Therapist:
The
Personal Feedback Report summarizes results from your pre
treatment evaluation. Your therapist has explained these to you. This
information is to help you understand the written report you have
received and to remember what your therapist told you.
Your report consists of two sheets. The first sheet provides information from
your pretreatment interviews. Attached to this is a second sheet summarizing
your answers to a questionnaire, the Alcohol Use Inventory. The following
information is presented section by section to help you understand what your
results mean.
Your The first line in this section
shows the number of drinks that you
Drinking reported having in a typical
drinking week. Because different alcohol
beverages vary in their strength,
we have converted your regular
drinking pattern into standard
"one drink" units. In this system, one
drink is equal to:
ONE STANDARD DRINK IS: 4 ounces of table wine (12
percent alcohol) or
WINE · 2.5 ounces of fortified wine (sherry,
port, etc.) (20 percent alcohol) or
BEER - 10 ounces of beer (5 percent
alcohol) or
80 PROOF LIQUOR - 1.25 ounces of 80 proof liquor
(40 percent alcohol) or
100 PROOF LIQUOR - 1 ounce of 100 proof liquor
(50 percent alcohol)
All of
these drinks contain the same amount of the same kind of alcohol: one-half
ounce of pure ethyl alcohol.
This
first piece of information, then, tells you how many of these standard drinks
you have been consuming per week of drinking, according to what you reported in
your interview. (If you have not been drinking for a period of time recently,
this refers to your pattern of drinking before you stopped.)
To give
you an idea of how this compares with the drinking of American adults in
general, the second number in section 1 is a
percentile figure. This tells you what percentage of U.S. men (if you area man)
or women (if you are a woman) drink less than you reported drinking in a
typical week of drinking. If this number were 60, for example, it would mean
that your drinking is higher than 60 percent of Americans of your sex (or that
40 percent drink as much as you reported, or more).
How much
is too much? It depends on many factors. Current research indicates that people
who average three or more standard drinks per day have much higher risk
of health and social problems. For some people, however, even 1-2 drinks per
day would be too many. Pregnant women, for example, are best advised to abstain
from alcohol altogether, because even small amounts of regular drinking have
been found to increase risk for the unborn child. Certain health problems (such
as liver disease) make even moderate drinking unsafe. Some people find that
they are unable to drink moderately, and having even one or two drinks leads to
intoxication.
Your
total number of drinks per week tells only part of the story. It is not healthy,
for example, to have 12 drinks per week by saving them all up for Saturdays.
Neither is it safe to have even a few drinks and then drive. This raises the
important question of level of intoxication.
2. Level of A second way of looking at your past drinking is to ask what level
of
Intoxication intoxication you have been reaching. It is possible to estimate
the
amount of alcohol that would be circulating in your bloodstream, based
on the pattern of drinking your reported. Blood alcohol concentration
(BAC) is an important indication of the extent to which alcohol would
be affecting your body and behavior. It is used by police and the courts,
for example, to determine whether a driver is too impaired to operate
a motor vehicle.
To understand better what BAC means, consider the list of common
effects of different levels of intoxication.
Common Effects of Different Levels of Intoxication
20-60
mgr/o This is
the "normal" social drinking range. NOTE: Driving, even at these
levels, is unsafe.
80 mg%
Memory, judgment, and perception are impaired. Legally intoxicated in some
States.
100 mg%
Reaction time and coordination of movement are affected. Legally intoxicated in
all States.
150 mg%
Vomiting may occur in normal drinkers; balance is often impaired.
200 mg%
Memory "blackout" may occur, causing loss of recall for events
occurring while intoxicated.
300 mg%
Unconsciousness in a normal person, though some remain conscious at levels in
excess of 600 mg% if tolerance is very high.
400-500
mg% Fatal dose for a normal person, though some survive higher levels if
tolerance is very high.
The two
figures shown in section 2 are computer-calculated estimates of your highest
(peak) BAC level during a typical week of drinking and during one of your
heaviest days of drinking.
It is
important to realize that there is no known "safe" level of
intoxication when driving or engaging in other potentially hazardous activities
(such as swimming, boating, hunting, and operating tools or machinery). Blood
alcohol levels as low as 40-60 mg% can decrease crucial abilities. Adding to
the danger, drinkers typically do not realize that they are impaired. The only
safe BAC when driving is zero. If you must drive after drinking, plan to allow
enough time for all of the alcohol to be eliminated from your body before
driving. The tables below can be helpful in determining how long it takes to
eliminate alcohol completely:
Approximate
hours from first drink to zero alcohol concentration levels for men
120 140 160 180 200 220 240 260
1 2 2 2 1.5 1 1 1 1
' Number 2 4 3.5 3 3 2.5 2 2 2
of 3 6 5 4.5 4 3.5 3.5 3 3
Drinks 4 8 7 6 5.5 5 4.5 4 3.5
5 10 8.5 7.5 6.5 6 5.5 5 4.5
One
drink = 10 oz of beer or 4 oz of wine or 1 oz of liquor (100 proof)
Approximate
hours from first drink to zero alcohol concentration levels for women
1 3
2.5 2 2 2 1.5 1.5 1
Number
2 6 5 4 4 3.5 3 3 2.5
of 3 9
7.5 6.5 5.5 5 4.5 4 4
Drinks
4 12 9.5 8.5 7.5 6.5 6 5.5 5
5 15
12 10.5 9.5 8 7.5 7 6
One drink = 10 oz
of beer or 4 oz of wine or 1 oz of liquor (100 proof)
Risk Factors It is clear that some people have a much higher risk of alcohol
and other drug problems. This section provides you with some information about
your own level of risk, based on your personal characteristics. "High
risk" does not mean that one will definitely have serious problems with
alcohol or other drugs. Neither does "low risk" mean that one will be
free of such problems. High-risk people, however, have greater chances of
developing serious problems.
Tolerance Your peak BAC levels, given in section 2, are one reasonably good
reflection of your level of tolerance for alcohol. If you
are reaching BAC
levels beyond the normal social drinking range (especially if you
are
not feeling some of the normal effects of lower BACs), it means
that
you have a higher tolerance for alcohol. This is partly hereditary
and
partly the result of changes in the body that occur with heavier
drinking. Some people are proud of this tolerance-the ability
"to hold
your liquor"-and think it means they are not being harmed by
alcohol.
Actually, the opposite is true. Tolerance for alcohol may be a
serious
risk factor for alcohol problems. The person with a high tolerance for
alcohol reaches high BAC levels, which can damage the brain and
other organs of the body but has no built-in warning that
it is happen
ing. Tolerance is not a protection against being harmed by
drinking;
to the contrary, it makes damage more likely because of the false
confidence that it encourages. It is a bit like a person who has
no sense
of pain. Pain is an important warning signal. People who feel no
pain
can seriously injure themselves without realizing it. It is the
same with
people who have a high tolerance for alcohol.
Many people believe that tolerance ("holding your
liquor") means that
a person gets rid of alcohol at a faster rate than others.
Although people
do differ in how quickly their bodies can clear alcohol, tolerance
has
more to do with actually being at a high blood alcohol
level and not
feeling it.
Other Drug Use A person who uses other drugs
besides alcohol runs several additional
risks. Decreased use of one drug may simply result in the
increased
use of another. The effects of different drugs can multiply when
they
are taken together, with dangerous results. A tolerance to one
drug
can increase tolerance to another, and it is common for multiple
drug
users to become addicted to several drugs. The use of other drugs,
then,
increases your risk for serious problems. Based on the lifetime
drug
use that you reported during your interview, your risk in this
regard
was judged to be low, medium, or high.
Family Risk People who have a family history of alcohol or other drug problems
among
their blood relatives clearly are at higher risk themselves. The
exact
reason for this higher risk is unknown, but it appears that the
risk is
inherited to an important extent. People may inherit a higher
tolerance
for alcohol or a body that is particularly sensitive to alcohol
in certain ways. In any event, a family history of alcohol
problems
increases personal risk.
Personality Pattern Although there is no single
personality style associated with alcohol
and drug problems, certain patterns are linked to higher risk. One
questionnaire you completed-the MacAndrew Scale-measures this
particular kind of risk. People who score higher on this scale as
teenagers, for example, have been found to have higher risk for
developing serious problems with alcohol in adulthood.
Age at Onset Recent research indicates that
the younger a person is when drinking
problems start, the greater the person's risk for developing serious
consequences and dependence. Although serious problems can occur
at any time of life, a younger beginning does represent a significant
risk factor.
l
Negative Consequences From your pretreatment interview, two scores were calculated to
reflect the current overall
severity of your negative consequences from drinking.
AUDIT The
AUDIT is a scale
devised by the World Health Organization to evaluate a person's problematic
involvement with alcohol. Higher scores reflect recent problems related to
drinking.
DRINC Another
way to look at risks and effects of drinking is to add up alcohol's negative
effects throughout one's lifetime. Your score on this scale reflects the extent
to which your drinking has had negative effects over the course of your life
thus far. The higher your score, the more harm has resulted from your drinking.
Blood
Tests Your
pretreatment evaluation also included a blood sample. These
particular blood tests were chosen because they have been shown in
previous research to be negatively affected by heavy drinking. You
should realize that normal results on these tests do not guarantee that
you are in good health (for example, that your liver is functioning
completely normally). An abnormal score on one or more of these tests,
however, probably reflects unhealthy changes in your body resulting
from excessive use of alcohol and/or other drugs.
Research indicates that modestly abnormal scores on the blood
tests
reported here will often show improvement and a return to normal
range when harmful drinking and other drug use patterns are
changed. The longer one continues drinking, however, the more diffi
cult it is to reverse the physical damage.
These
tests are directly related to how the liver is working. Your liver is extremely
important to your health. It is involved in producing energy, and it filters
and neutralizes impurities and poisons in your bloodstream. Alcohol damages the
liver, and after a long period of heavy drinking, parts of the liver begin to
die. This is the process of cirrhosis, but physical changes in the liver can be
caused by drinking long before cirrhosis appears. As the liver becomes damaged,
it begins to leak enzymes into the blood and is less efficient in doing its
work. This can be reflected in abnormally elevated values on the tests reported
in this section.
Elevated
values on any of these tests should be taken seriously. They do not happen by
chance and are very likely related to physical changes in the body caused by
excessive drinking. Consult a physician who is knowledgeable about the effects
of alcohol on the body.
Neuropsychological Tests
Some of
the earliest damaging effects of drinking may be seen in
certain types of abilities that are affected by alcohol. Certain
patterns
of brain impairment have been shown to be especially related to heavy
drinking. The brain is very vulnerable to alcohol, and over a long span
of time, a substantial amount of damage can occur in a heavy drinker.
(Brain impairment from the use of certain other drugs has also been
shown.)
Such damage occurs gradually. In later stages, it can be seen in x
rays
of the brain, which show actual shrinkage and other changes in shape
and density. Long before this occurs, however, harmful changes in
brain functioning can be measured by psychological tests, several of
which you completed. Research indicates that such negative effects
can often be reversed, sometimes completely, if the individual stops or
reduces drinking.
The four tests included in section 6 have been found to be related
to
heavy drinking. For comparison purposes, we include one test (SV)
that is not usually affected by drinking to give you an idea of where
your scores might normally be expected to fall. People who are heavy
drinkers tend to score more poorly (higher) on the four alcohol-sensi
tive tests (TMTA, TMTB, SYDM, and SHVA) than on SV.
A high score on any one scale is not necessarily reason for concern.
There are many reasons why a single score might be elevated. A
pattern of elevated scores, however,
resembles the kinds of problems
that emerge among excessive drinkers. Studies of individuals cur
rently in treatment for alcohol problems consistently show impair
ment on these measures.
Alcohol's effects on the brain have sometimes been described as
"pre
mature aging." The abnormal changes in the brain of a heavy drinker
do resemble normal changes that occur with advanced age. For this reason, your
scores reflected above take into account your present age. Scores of 4 or 5
represent below-average performance relative to others in your age group.
The Alcohol You completed a longer questionnaire
that asked in detail about your
Use Inventory drinking. This questionnaire has
been given to thousands of people
seeking treatment for alcohol problems. Based on your answers, scores were
obtained, and these are shown on the Alcohol Use Inventory Profile section of
your Personal Feedback Report.
Notice that each score falls into one of three ranges. The white .range
indicates a low score, the light grey range is for medium scores, and
the dark grey range reflects high scores-compared to other
people in
treatment for alcohol problems. If, for example, your score for the
"Quantity" scale (#13) was in the medium (light grey) range, it would
mean that you drink about an average amount for people already
receiuing treatment for alcohol problems. This would be far above the
average amount of drinking for Americans in general.
Here are brief reminders of what each scale means. If you want to
discuss your results in more detail, contact your therapist.
The first four scales reflect possible reasons for excessive drinking. A
high score on one of these scales may indicate a way in which you have
come to depend on alcohol. In order to be free of alcohol problems, it
would be important to find other ways of dealing with these areas of
your life.
Social Improvement Drinking
People who score
in the medium or high range on this scale tend to be
social drinkers. They may use alcohol to relax and feel more comfort
able around others, to be friendly, or to enjoy social events more. They
might have difficulty knowing how to handle their social lives without
alcohol.
Mental Improvement Drinking
Those who score
medium or high on this scale tend to like the way
alcohol changes their thinking or mental state. They indicate that
when they drink they feel more creative or alert, work better, or see
the world in more enjoyable ways.
Managing Mood With Drinking
On this
scale, medium or high scores indicate people who use alcohol to change how they
feel. They drink to forget, to feel less anxious or depressed, or to escape
from unpleasant moods. Without alcohol, they might experience difficulty coping
with their own emotions.
Marital
Coping by Drinking
(If you
are not married, you will have no score here.) People who score in the medium
or high range on this scale report that they drink because of problems in their
marriage.
Styles of The next three scales reflect different styles of using
alcohol. Low
Drinking scores on these scales describe a different style of drinking
but do not
mean that there are no problems.
Gregarious
Drinking
A medium or high
score indicates a preference for drinking around
other people. Those who prefer to drink alone score low on this scale.
Compulsive Drinking
Medium and high scores on scale 6 indicate a close attachment to
alcohol. Such people tend to think about alcohol a lot, keep a supply
handy, and drink in a "compulsive," predictable style.
Sustained Drinking
People who score in the medium and high range on this scale tend to
be regular, steady drinkers, drinking every day or most days. Those
who score lower on this scale are not such steady drinkers but have
periods of drinking and nondrinking.
Consequences Scales 8-12 reflect possible negative consequences of drinking.
Higher
scores on these scales reflect more problems, compared with people
already in treatment for alcohol problems. Thus, a person with a lower
score may still have some problems but fewer than most people now
in treatment for alcohol problems.
Loss of Control
One kind of difficulty that people can have is that they lose control of
themselves when drinking. They get into trouble, arguments, or fights.
They may do embarrassing things or hurt themselves or other people.
They may not remember things that happened while drinking (black
outs) or
may drink until they become unconscious. Medium and high scores indicate these
kinds of problems.
Role
Problems
Drinking
can also cause social difficulties, such as problems at work or school, and
conflicts with the law. Medium and high scores indicate that alcohol is
seriously interfering with social functioning.
Delirium
If people
continue to drink heavily over a period of time, they may develop a pattern of
physical dependence on alcohol. A number of changes occur, usually gradually, that
make it more difficult for a person to live without alcohol. This can include
actual addiction to alcohol, so that the person becomes uncomfortable or even
ill when stopping or cutting down drinking. Medium to high scores on this scale
reflect some of the more serious signs of addiction to alcohol. For example,
stopping drinking can result in hallucinations (seeing, hearing, or feeling
things that are not really there) or fuzzy thinking.
Hangover
Hangovers are
actually a form of alcohol withdrawal, the body's "rebound" reaction
to alcohol. Medium or high scores on scale 11 reflect some of these signs of
addiction to alcohol: feeling shaky or sick to the stomach, feeling your heart
racing, having a seizure, or feeling hot or cold flashes when sobering up.
Marital Problems
People
who score in the medium or high range of scale 12 report that they are having
problems in their marriage because of their drinking. (If you are not married,
this scale will be blank.)
Personal How much do you recognize and acknowledge problems with drinking?
Concern This is what scales 13-17 describe.
Quantity of Drinking
Scale 13
is a rough indicator of the amount you said you have been drinking. (Section 1 of your
Personal Feedback Report is a more accurate indication.) Remember that this is
in comparison to other people seeking treatment for alcohol problems.
Guilt/Worry
To what
extent have you felt guilty about your drinking or worried about what it is
doing to you and those around you? Medium and high scores reflect more of this
kind of concern.
Help
Before
To what
extent have you sought help for your drinking before coming to this program?
The more things you have tried before, the higher this score will be.
Receptiveness
To what
extent do you feel ready and willing to receive help for your drinking? Medium
and high scores reflect greater willingness to accept help.
Awareness
To what
extent are you aware of problems being caused by your drinking? Medium and high
scores indicate recognition of more serious problems.
Second Order Scales Scores A through F are summaries. They do not contain new informa
tion but rather combine
information from scales 1-17. Nevertheless,
they are useful as overall problem indicators.
Enhancement Drinking
Medium and high scores on this scale reflect drinking to cope, to
enhance your life, or to get what you perceive to be the benefits
of
drinking. To the extent that this score is high, there would be some
challenges to face in changing your drinking, because you have
relied
on alcohol for these purposes. Scales 1-5 show you where you may
have
relied most on alcohol to enhance your life.
Obsessive Drinking
Medium and high scores on this scale indicate what are often
thought
of as classic "alcoholic" drinking patterns. The
drinking of high scorers
on this scale tends to be steady and "driven," occupying
much of the
person's time and energy. High scorers think about drinking quite
a
bit and will go to considerable lengths to make sure they can
drink. It
has become a central part of their lives.
Disruption
Both of these two scales report the extent to which life has been disrupted by
drinking. Medium and high scores indicate serious symptoms and problems
resulting from drinking.
Anxious
Concern
Medium
and high scores on this scale indicate worry, anxiety, or concern about
drinking, as well as alcohol's negative effects on the person's emotional life.
Recognition and Awareness
Medium and high scores here indicate a recognition of a need for change in
drinking and/or willingness to get help with drinking.
General Finally,
the Alcohol Involvement Scale is one general indicator of the overall severity
of alcohol problems. The higher this score, the more serious and severe the
alcohol problems. Remember that scores are low, medium, or high in relation to people
already in treatment for alcohol problems.
Summary Your Personal Feedback Report summarizes a large amount of
information that you provided during your pretreatment interviews. Sometimes
this information can seem surprising or even discouraging. The best use of
feedback like this is to consider it as you decide what, if anything, you will
do about your drinking. Many of the kinds of problems covered in your Personal
Feedback Report do improve when heavy drinking is stopped. What you do with this
information is up to you. Your report is designed to give you a clear picture
of where you are at present so that you can make good decisions about where you
want to go from here.
