The “WILD” side– History taking for substance abuse

This week we have a set of memory aids that you may use when assessing your patient for substance use.

1)  Is your patient running “WILD”? If they have impairment or distress secondary to substance usage for >12 months and at least 1 of the WILD criteria, they have a substance abuse problem:

W = Intereferes with obligations at Work, school or at home.
I = Continued usage despite Interpersonal or social consequences
L = Legal problems related to substance usage
D = Usage in Dangerous situations

2) The CAGE questionnaire is a commonly-used screening tool for alcoholism. Each letter of the acronym is a question in the questionnaire. If the patient answers “yes” to 2 or more of the CAGE questions, the possibility of alcoholism should be explored.

C = Have you ever felt that you need to Cut down on your drinking?
A = Have you ever been Annoyed when others criticized your drinking?
G = Have you ever felt bad or Guilty for drinking?
E = Have you ever had a drink first thing in the morning (i.e. as an Eye-opener) to calm your nerves or rid yourself of a hangover? 

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Thanks for reading! Have a great week!

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