The following information may help clinicians when treating emergency workers

The National Health and Medical Research Council (NHMRC) advises that there is no level of alcohol consumption that is completely safe, and the less people drink then the lower their risk of alcohol-related harm. Furthermore, the NHMRC has issued draft guidelines for reducing the health risks from drinking in Australia, and these indicate that healthy men and women should drink no more than: (a) 10 standard drinks per week; and (b) 4 standard drinks on any one day. Men and women who drink in excess of these guidelines should be advised to try and reduce their drinking in order to minimise their risk of alcohol-related harm.

There are also different patterns of alcohol use which may signal increased health risks, and these include:

Teal tick

drinking alcohol every day

Teal tick

repeated episodes of drinking to intoxication

Teal tick

drinking which affects behaviours and contributes to physical or mental harm (e.g., drink driving)

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item measure that can also be used to inform discussions about drinking, or can be completed by self-report, and can be helpful to identify the level of risk and severity. Questions include:

Teal tick

How often do you have a drink containing alcohol?

Teal tick

How many drinks containing alcohol do you have on a typical day when you are drinking?

Teal tick

How often have you failed to do what was expected of you because of drinking?

If the individual scores 8-12 on the AUDIT then they may be classified as hazardous or risky drinkers, while scores of 13+ may signal high risk of harmful drinking or alcohol dependence.

Quick tips

Screening and initial assessment

In the aftermath of disaster, individuals may not be fully aware that their alcohol use has changed or increased their risk of consequences, and screening (or routine questioning) in frontline services should be considered to identify people who might benefit from an intervention. The World Health Organisation has developed the AUDIT for such purposes, and the first three consumption questions (called the AUDIT-C) may be useful when time and resources for screening are limited.

However, where resources are permitting, then initial assessments may also consider the range of problems that have been caused by drinking, as well as the severity of alcohol dependence. The Alcohol Problems Questionnaire (APQ) and the Severity of Alcohol Dependence Questionnaire (SADQ) may be used for such purposes. (see below).

Depending on the level of risk or severity of problems, there are different types of strategies that may then be considered.

Brief intervention

Individuals who are identified as hazardous or harmful drinkers may benefit from a brief intervention, which have a long history in addressing alcohol misuse, and have been shown to be beneficial in reducing drinking behaviour. These brief alcohol interventions can range from 1-4 sessions, but may be a short as 5 minutes in a single session, and can be organised around elements of the FLAGS (feedback, listen, advice, goals, strategies) model:

  • Feedback: Provide feedback on the results of the AUDIT and identify risks of harm linked to current levels of drinking.
  • Listen: Listen to the individual’s response and discuss.
  • Advice: Provide clear and direct advice about the importance of reducing drinking.
  • Goals: Discuss specific goals for changing behaviour
  • Strategies: Discuss potential strategies for achieving these goals, such as setting limits on alcohol consumption, or developing skills to avoid drinking in high-risk situations.

Referral to specialist treatment and support services

Individuals who are identified as harmful drinkers, and particularly those who are alcohol dependent, may require and benefit from referral or engagement with specialist alcohol treatment. There are different types of services which may include counselling, residential or non-residential withdrawal services, as well as intensive structured programs that may be offered on a residential or non-residential basis. Specialist alcohol treatment services are likely to provide many of the following:

  • Comprehensive assessments: These will often address histories of alcohol consumption, severity of alcohol dependence and alcohol-related problems, co-occurring drug use, health and psychosocial problems, as well as readiness to change. The results of a comprehensive assessment will help identify appropriate treatment and support needs.
  • Assisted withdrawal: Severe alcohol dependence may be accompanied by physiological symptoms of withdrawal that require additional management when individuals are first attempting to reduce drinking. In some instances there may be safety concerns which indicate the need to medical assistance in a residential or non-residential setting.
  • Psychological interventions: These interventions are commonly based on cognitive-behavioural approaches and focus on alcohol-related cognitions, behaviours, and social networks. Cognitive interventions may involve simple explorations of the individual’s cognitions about alcohol use with the aim to develop more balanced thinking about the impacts of drinking. Behavioural interventions may involve provision of training on behaviours which can reduce substance use to desired levels, such as delay, distraction, and deep breathing.

Do you know how to

Administer the AUDIT screening measure, including the brief AUDIT-C?

Assess impact of alcohol use on individual/individual’s health or social functioning?

Provide feedback on AUDIT?

Provide brief advice to reduce drinking?

Provide appropriate referrals for specialist alcohol treatment?

Relevant Resources


For urgent support
call Lifeline on

Call 13 11 14

Confidential 24/7
counselling and referrals

Lifeline website