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If you need to determine whether patients are low-risk, increased-risk, or high-risk for alcohol abuse, or high-risk for alcohol dependency, you can use the RAPS4-QF:

R: REMORSE – Feelings of guilt, remorse, or regret after drinking.
A: AMNESIA – Memory lapses associated with drinking.
P: PERFORMANCE – Impeding patients' ability to function as normally expected of them.
S: STARTER / EYE OPENER – Needing a drink first thing in the morning.
Q: QUANTITY – Men are at higher-risk if they drink five or more drinks on one occasion; women if they have four or more.
F: FREQUENCY – Drinking as often as once a month in the past year indicates higher risk.

Patients are at low-risk if they answer "no" to all questions, or "yes" to question 6 but "no" to all others. Patients who answer "yes" to question 5, or to both questions 5 and 6, but "no" to questions 1-4, are at high-risk and would benefit from a brief intervention. Patients who answer "yes" to any of questions 1-4, and require a brief intervention and further diagnostic evaluation.

You can also ask patients about their experiences with drinking by asking:

• 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?

It's best to do a brief intervention immediately after a positive screening to change a patient's behavior. Your goal is to get patients to identify reasons for them to change their behaviors themselves, and then provide them with the resources to do so. You can use the FLO framework:

F: Feedback. Ask patients how they think they did, and tell them their score.
L: Look. Look for patients' reasons to change.
O: Option. Ask what options patients think they have, and provide others.

When conducting a brief intervention, remember to be optimistic, assure patients that the choice of what they do is up to them, summarize the pros and cons they've communicated about making a change, avoid labeling or judging, and most importantly, make the patients feel valued and respected.