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Substance Misuse

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Clinical Forensic Medicine

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Abstract

The number of individuals passing through the criminal justice system with ­substance misuse problems is increasing and it is essential that healthcare ­professionals are aware of the current drug trends in their area and have been trained to a standard to practice competently in this field.

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Author information

Authors and Affiliations

  1. Faculty of Forensic and Legal Medicine, London, UK

    Margaret M. Stark (Founding Academic Dean)

  2. Faculty of Forensic and Legal Medicine, Bristol, UK

    Guy A. Norfolk (Founding President)

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  1. Margaret M. Stark
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Correspondence to Margaret M. Stark .

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    Margaret M. Stark

Appendix: Alcohol Assessment Questionnaires

Appendix: Alcohol Assessment Questionnaires

The Brief MAST

Questions

Yes

No

(Score)

 

 1.

Do you feel you are a normal drinker?

0

2

 2.

Do friends or relatives think you’re a normal drinker?

0

2

 3.

Have you ever attended a meeting of Alcoholics Anonymous?

5

0

 4.

Have you ever lost boyfriends/girlfriends because of drinking?

2

0

 5.

Have you ever got into trouble at work because of drinking?

2

0

 6.

Have you ever neglected your obligations, your family or your work for more than 2 days in a row because you were drinking?

2

0

 7.

Have you ever had DTs, severe shaking, heard voices or seen things that weren’t there after heavy drinking?

2

0

 8.

Have you ever gone to anyone for help about your drinking?

5

0

 9.

Have you ever been in hospital because of drinking?

5

0

10.

Have you ever been arrested for drunk driving or driving after drinking?

2

0

The brief MAST is useful as a quick screening instrument to distinguish between alcohol dependent (a score of 6 or above) and nonalcohol dependent individuals

Pokorny et al. [222]

The CAGE Questionnaire

1.Have you ever felt you should Cut down on your drinking?

2.Have people Annoyed you by criticising your drinking?

3.Have you ever felt bad or Guilty about your drinking?

4.Have you ever had a drink first thing in the morning to steady your nerves, or to get rid of a hangover (Eye-opener)?

Two or more positive responses sensitive indicator of alcohol dependence.

Mayfield et al. [224]

The AUDIT Questionnaire

Circle the number that comes closest to the patient’s answer.

 1.How often do you have a drink containing alcohol?

(0) NEVER

(1) MONTHLY OR LESS

(2) TWO TO FOUR TIMES A MONTH

(3) TWO TO THREE TIMES A WEEK

(4) FOUR OR MORE TIMES A WEEK

 2.How many drinks containing alcohol do you have on a typical day when you are drinking? (CODE NUMBER OF STANDARD DRINKS)

(0) 1 OR 2

(1) 3 OR 4

(2) 5 OR 6

(3) 7 OR 8

(4) 10 OR MORE

 3.How often do you have six or more drinks on one occasion?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 4.How often during the last year have you found that you were not able to stop drinking once you had started?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 5.How often during the last year have you failed to do what was normally expected from you because of drinking?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 6.How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 7.How often during the last year have you had a feeling of guilt or remorse after drinking?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 8.How often during the last year have you been unable to remember what happened the night before because you had been drinking?

(0) NEVER

(1) LESS THAN MONTHLY

(2) MONTHLY

(3) WEEKLY

(4) DAILY OR ALMOST DAILY

 9.Have you or someone else been injured as a result of your drinking?

(0) NO

(2) YES, BUT NOT IN THE LAST YEAR (4) YES, DURING THE LAST YEAR

10.Has a relative or friend or a doctor or other health worker, been concerned about your drinking or suggested you cut down?

(0) NO

(2) YES, BUT NOT IN THE LAST YEAR (4) YES, DURING THE LAST YEAR

*  In determining the response categories it has been assumed that one “drink” contains 10 g alcohol. In countries where the alcohol content of a standard drink differs by more than 25% from 10 g, the response category should be modified accordingly

Record sum of individual item scores here ______

A score of 8 produces the highest sensitivity; a score of ten or more results in higher specificity. In general high scores on the first three items in the absence of elevated scores on the remaining items suggest hazardous alcohol use. Elevated scores on items 4 through 6 imply the emergence of alcohol dependence. High scores on the remaining items suggest harmful alcohol use

For details see: Babor et al. [220]

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Stark, M.M., Norfolk, G.A. (2011). Substance Misuse. In: Stark, M. (eds) Clinical Forensic Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-258-8_12

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