Personnel may feel insufficiently trained to carry out the interventions, or feel they lack the support of existing specialist alcohol services. In its strategy proposals Alcohol Concern advocates the use of a standard alcohol misuse screening tool within primary care and hospital settings. Alcohol Concern s proposals include recommendations that each general hospital has a strategy for detecting and responding to alcohol problems and that alcohol targets are included within Health Improvement Programmes, with targets set for each agency responsible for funding alcohol services, including the health authority and Primary Care Groups, social services and probation services . Screening tests have been designed to be used by non-specialists, thereby enabling the detection of alcohol problems and identification of treatment options to take place. There are four instruments that have been well validated for use in primary care settings.
CAGE is the most widely used test in clinical practice.
It focuses on the client s lifetime rather than current drinking. Two or more positive responses indicate the need for further assessment. Like the CAGE questionnaire, the MAST is also worded so that it tends to identify lifetime rather than current alcohol related problems, thus limiting the likelihood of detecting early problem drinkers. It covers alcohol dependence, alcohol induced problems and amount and frequency of drinking. Although, as stated above, pencil and paper tests should not be seen as an alternative to a personal interview, they do provide standardised and quantified data which can be used as a measuring instrument.