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How do we determine the level of risk based on the patient's answers?

Patients are at low-risk if they answer "no" to all of the questions in the RASP4-QF, or if they answer "yes" to question 6, about frequency, but "no" to all others. These patients should be given positive reinforcement for their low-risk drinking behaviors.

Patients who answer "yes" to question 5, about quantity, are engaging in heavy episodic consumption, which places them at increased risk for alcohol-related harm. These patients should receive a brief intervention, which we'll talk more about later. Patients who answer "yes" to both questions 5 and 6, but "no" to questions 1-4, are at high-risk for alcohol abuse and would also benefit from a brief intervention.

If patients answer "yes" to any of questions 1-4, they're at high-risk for alcohol dependency, and require a brief intervention and further diagnostic evaluation.

You can also ask patients about their subjective experience of drinking and how alcohol has affected their health and relationships. Some questions you may ask could be:

• Have relatives or friends ever expressed concern about your drinking?
• Have you ever been injured or injured someone else after or while you've been drinking?
• How does drinking a few drinks affect you now versus when you first started drinking?
• And, what do you like or dislike about drinking?

Answers to these additional topics can help you determine patients' level of risk.