Inquiring about alcohol use in clinical practiceInquiring about alcohol use in clinical practice
Addiction Practice Pod
Healthcare providers hear from a councillor in long‑term recovery and an addiction physician about asking patients about alcohol use with less stigma and more clarity. The conversation outlines simple clinical questions, diagnostic tips and treatment options for alcohol use disorder alongside community‑level policy work.
37:54•20 Apr 2026
Asking About Alcohol Use: Real Stories and Practical Tips for Clinicians
Episode Overview
- Ask about alcohol use routinely, frame it as standard care, and normalise the conversation to reduce shame.
- Move beyond vague descriptions and get a concrete sense of how much, how often and what patients are drinking so change can be tracked.
- Link alcohol use to conditions like hypertension, insomnia, atrial fibrillation and breast cancer to support informed decisions.
- Use DSM‑5 criteria to diagnose alcohol use disorder and consider effective first‑line medications such as naltrexone and acamprosate.
- Remember that alcohol often fills a role in people’s lives; approach with "an open heart and an open mind" to support individual recovery paths.
“They don't use alcohol or drugs because they suck. They're doing something for them. They just come with a lot of downsides.”
How do people find strength in their journey to sobriety? This episode of Addiction Practice Pod brings together policy, lived experience, and practical medicine to help clinicians ask better questions about alcohol use. Host David Ball chats with Tofino district councillor Tom Steer, who speaks candidly about a hidden, decades-long alcohol use disorder that few in his community suspected.
Tom explains how hangovers, isolation and strain on his relationship with his sons finally pushed him towards recovery, calling it one of his "biggest life-changing decisions". He also describes how a local presentation declaring alcohol the region’s top health and safety issue sparked his shift into municipal alcohol policy and a wider community alcohol strategy.
Alongside Tom, family doctor and addiction specialist Dr Olivia Brooks breaks down how primary care providers can ask about alcohol in a way that feels safe rather than shaming. Her starting point: "substances do fill a role in people's lives.
They don't use alcohol or drugs because they suck." She shares simple, time‑efficient steps: clearly flagging that substance use is part of the routine history, normalising the questions, and pushing past vague answers like "not that much" to concrete amounts so progress can be tracked. Olivia also tackles diagnosis and treatment, stressing that alcohol use disorder is a medical condition with effective options.
She highlights first‑line medications such as naltrexone, with a number needed to treat of 9, and illustrates their impact with a patient whose drinking halved and who, with added supports, became abstinent long enough to safely undergo cataract surgery.
Her analogy for ignoring alcohol’s role in health problems is memorable: it’s "like mopping the floor instead of just turning off the faucet." If you work in primary care and wonder how to ask about alcohol without making patients bolt for the door, this conversation might be the nudge to start that next brave question.
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