Clinical tools​

Tools and forms

Alcohol Use Assessment Form 

A tool developed by the Addiction Shared Care Program at St. Joseph's Health Centre, Toronto, to facilitate a comprehensive alcohol use assessment.

ALPHA form

A tool designed to help health care providers assess psychosocial health in pregnancy.

See: Screening for alcohol use in pregnancy

Assessment of Living Skills and Resources (ALSAR)

See: Assessing alcohol problems in women

AUDIT-10: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care (2nd ed.). Geneva, Switzerland: World Health Organization.

Manual: Includes the AUDIT questionnaire and describes how to use it to identify people with hazardous and harmful patterns of alcohol consumption. 

Questionnaire only

See: Screening for alcohol problems in primary care and Assessing alcohol problems

AUDIT-C

This alcohol screener includes the first three questions of the AUDIT-10.

See: Screening for alcohol problems in primary care

The Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar)

A standardized clinical tool that facilitates assessment of alcohol withdrawal.

See: Alcohol withdrawal

Hamilton Rating Scale for Anxiety (HAM-A)

A rating scale that quantifies the severity of anxiety symptomatology. It is often used in psychotropic drug evaluation. The HAM-A contains 14 items, each defined by a series of symptoms.

See: Assessing alcohol problems in women

Hamilton Rating Scale for Depression (HAMD-7)

A tool to use in primary care settings to measure depression.

See: Identifying concurrent alcohol use and depressive disorders

Patient Health Questionnaire (PHQ-9)

A self-administered screening tool for depression.

See: Identifying concurrent alcohol use and depressive disorders 

Short Michigan Alcohol Screening Test –Geriatric version (SMAST-G)

SMAST-G is a version of the Short Michigan Alcohol Screening Test modified for the geriatric population.

See Screening for alcohol problems: Older adults

T-ACE

T-ACE is a measurement tool featuring four questions that are significant identifiers of risk drinking (i.e., alcohol intake sufficient to potentially damage the embryo/fetus).

See: Screening for alcohol problems in women and Screening for alcohol use in pregnancy

TWEAK

TWEAK is a five-item scale developed originally to screen for risk drinking during pregnancy.

See: Screening for alcohol problems in women and Screening for alcohol use in pregnancy

Templates

Decisional Balance Sheet

A tool designed to facilitate discussion between care providers and clients about the pros and cons of alcohol and other substance use.

Goal setting and Drinking Diary template

Request for an Unlisted Drug Product

The Exceptional Access Program, Ontario Ministry of Health and Long-Term Care, provides a form that physicians complete to request coverage for unlisted drugs for patients whose drug costs are covered by the Ontario Drug Benefit Program.