What Is an Alcohol Evaluation?

What Is an Alcohol Evaluation?
What Is an Alcohol Evaluation? (Image: http://pubs.niaaa.nih.gov/publications/niaaa-guide/images/Fig2.jpg, http://seshdotcom.files.wordpress.com/2008/12/alcoholism.jpg, http://pubs.niaaa.nih.gov/publications/Social/Module4Screening/slide9.jpg, http://www.alcoholism-treatment.org/images/header.jpg)

It's common for people who are heavily intoxicated to be admitted to an emergency room for treatment. Upon arrival, an alcohol evaluation assessment is taken to determine the person's overall health status and treatment needs. Assessment information can be gathered from the patient or from whoever accompanies him at the time of admission. Three assessment models are used: MAST, CAGE and TWEAK.

MAST Evaluation

The Michigan Alcohol Screening Test (MAST) was developed in 1971 and is one of the oldest assessment tools available. The test is designed to be a self-appraisal of how the patient sees her drinking and how it affects her life. It's a lengthy test that addresses drinking behaviors over the course of the patient's lifetime. Questions address problems within a person's family relationships, work relationships, work performance and social life.

CAGE Evaluation

The CAGE evaluation test is actually an acronym for the specific questions asked during the assessment. The letter "C" represents the first question, which is whether anyone has advised them to "cut" down on their drinking. The letter "A" represents the second question, which asks whether the patient has ever been "annoyed" by criticism regarding his drinking. The letter "G" represents questions regarding any feelings of "guilt" the patient might have regarding his alcohol intake. The letter "E" represents how often the patient drinks alcohol first thing in the morning (an "eye-opener") to calm the effects of a hangover or to calm his nerves.

TWEAK Evaluation

TWEAK also is an acronym for the questions posed by the evaluation. The letters stand for tolerance, worried, eye-openers, amnesia and cut down. Questions about tolerance address how many drinks the patient can hold. "W", or worried, asks whether relatives or close friends have expressed concern regarding the patient's drinking. Eye-openers refers to early morning drinking. Questions regarding amnesia have to do with whether the patient has had blackouts. "Cut down" refers to whether the patient has ever wondered whether she should cut down on drinking.

Physical Assessment

By the time a person has reached the point where an alcohol evaluation is necessary, other physical ailments are most likely present as well. As alcoholism is a progressive disease, it's not uncommon for a person's overall physical condition to decline over time. Malnutrition, as well as vitamin and mineral deficiencies, is possible. Persons admitted to the emergency room often undergo symptoms of withdrawal once they enter a detoxification program. Withdrawal symptoms can include tremors, hallucinations, fever and seizures.


The information gathered from an alcohol evaluation provides clues as to what method of treatment will work best. In cases of severe alcoholism, patients are admitted to a detoxification program. Once all traces of alcohol are out of the patient's system, the patient might be prescribed anti-anxiety or anti-depressant medications to help reduce any effects of withdrawal. Once detox is completed, patients might be assigned to an after-care program where routine psychotherapy and group therapy sessions can be attended. At this point, patients typically re-establish their normal routines. Many regularly attend Alcoholics Anonymous meetings for support.

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