Identify patients requiring further evaluation.
Office screening protocol
High index of suspicion when suggestive constellations of findings
Information about alcohol use and sequela
Pattern and amount
Social, family, legal, medical sequelae
Prior personal history
Family history
Determine patient readiness to discuss treatment.
Assess patients requiring detoxification.
Determination of risk for complicated withdrawal
History of severe withdrawal symptoms, seizures or delirium tremens
Unstable concomitant medical conditions
Impairment of cognition and self-care
Extent of family support
Availability of a prompt way to obtain higher level of care if outpatient detoxification is initiated
Plan for postdetoxification treatment in coordination with other professionals.
Determination of resources and limitations
Patient preferences
Eligibility for treatment programs
Insurance coverage
Availability of community support groups
Transportation
Family involvement
Considerations for frail elders
Comprehensive geriatric assessment
Community-agency referrals as appropriate
Nursing facility placement in certain situations