CSAP's Prevention Pathways

This questionnaire asks about patients’ experiences in the past year. If responses are ambiguous or evasive, continue asking for clarification and ask the patient to choose the response closest to his or her experience. If the patient does not drink on a regular basis, recording the drinking pattern can be difficult. For example, if the patient was drinking heavily in the month before an accident but has not had any alcohol since, it will be difficult to characterize the "typical" drinking pattern.

Using the amount of drinking and related symptoms for the heaviest drinking period of the past year will provide the most useful information. However, clinicians need to make a note of the special circumstances and time period assessed for that particular patient.

In the past year:
	YES	NO
When talking with others, do you ever underestimate how much you actually drink?	___ (1)	___ (0)
After a few drinks, have you sometimes not eaten or been able to skip a meal because you didn’t feel hungry?	___ (1)	___ (0)
Does having a few drinks help decrease your shakiness or tremors?	___ (1)	___ (0)
Does alcohol sometimes make it hard for you to remember parts of the day or night?	___ (1)	___ (0)
Do you usually take a drink to relax or calm your nerves?	___ (1)	___ (0)
Do you drink to take your mind off your problems?	___ (1)	___ (0)
Have you ever increased your drinking after experiencing a loss in your life?	___ (1)	___ (0)
Has a doctor or nurse ever said they were worried or concerned about your drinking?	___ (1)	___ (0)
Have you ever made rules to manage your drinking?	___ (1)	___ (0)
When you feel lonely, does having a drink help?	___ (1)	___ (0)

Short MAST-G