Shaping better health
REMEDY : BNSSG referral pathways

Alcohol Misuse

Checked: 10-05-2018 by Rob.Adams Next Review: 14-05-2019

AUDIT - assessment

The Alcohol Use Disorder Identification Test (AUDIT) has been developed by the World Health Organization as a simple screening tool to pick up the early signs of hazardous and harmful drinking and identify possible alcohol dependence.

Downloadable version for patient self assessment here.

FRAMES - brief intervention tool

Refer to the FRAMES model of intervention (powerpoint) for risky or harmful alcohol consumption, as provided by the Drug and Alcohol Clinical Advisory Service. It provides a suggested format for brief intervention in primary care.


Further advice and resources can be found in Clinical Knowledge Summary section - Alcohol - problem drinking.


For patients who required further help and support with regards their alcohol use then please refer to the local providers as below:

Bristol - Refer to Bristol ROADS

South Gloucestershire - Refer to the DHI

North Somerset - Refer to Addaction

Children (aged 17 and under) - see Children and Young People section of Remedy

Red Flags

Offer admission to hospital for immediate (unplanned) medically assisted alcohol withdrawal for people in acute alcohol withdrawal with, or who are likely to be at high risk of developing, alcohol withdrawal seizures or delirium tremens.

Urgently admit people with clinical features of Wernicke's encephalopathy (such as confusion, loss of coordination [ataxia], eye paralysis [ophthalmoplegia], nystagmus, memory disturbance, hypothermia, hypotension, and coma) for treatment with parenteral thiamine.

Please see the clinical protocol for Wernicke's Encephalopathy (WE) and Pabrinex that has been developed by UHBristol Trust to be used by nurses, doctors and pharmacists for assessment and intervention of adult inpatients suspected or at risk of WE due to alcohol misuse.

Detox in primary care

The BSDAS team have provided the following protocols to support GPs managing detox in primary care:

Standard dose Chlordiazepoxide regime

Medium dose Chlordiazepoxide regime

High dose Chlordiazepoxide regime


Pabrinex/ Thiamine scoring system