Screening Tools for Health and Social Service Providers
It is important for health and social service providers to have non-judgmental discussions with women in their child bearing years about their alcohol consumption and the effect alcohol can have throughout pregnancy on their unborn baby. Research has shown that having discussions with women when birth control is discussed about the importance of being alcohol free if they are planning a pregnancy, or if they suspect they are pregnant, can make a significant difference in their ability to abstain from alcohol use in pregnancy. The message of “No safe time, no safe kind, no safe amount” (Parkes et al. 2008) is regarded as a best practice guideline during the preconception period as it is estimated that 50% of all pregnancies in Canada are unplanned (Zeiman, 2009). This fact emphasizes the need for family physicians to provide education to their patients about the dangers of drinking during the child bearing years.
The T-ACE and TWEAK are both recommended screening tools to be used in pregnancy that can help health and social service providers identify women at risk of problem drinking and refer them to local services that will assist them to be alcohol free during pregnancy.
How many drinks does it take for you to feel high? (Tolerance)
Have people Annoyed you by criticizing your drinking?
Have you ever felt you ought to Cut down on your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (Eye-Opener)
Any woman who answers more than two drinks on the tolerance question is scored 2 points. Each yes to the additional three questions scores 1. A score of 2 or more is considered a positive screen, and the woman should be referred to a specialist for further assessment.
How many drinks does it take for you to feel high?
Does your partner (or do your parents) ever Worry or complain about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (Eye-opener)
Have you ever Awakened in the morning after some drinking the night before and found that you could not remember part of the evening before?
Have you ever felt that you ought to Cut down on your drinking?
Supporting Change: Effective Practices for Screening for Alcohol Use in Pregnant Women
Parkes, T., Poole, N., Salmon, A., Greaves, L., & Urquhart, C. (2008). Double exposure: A better practices review on alcohol interventions during pregnancy. Vancouver, BC: British Columbia Centre of Excellence for Women’s Health.
Zieman M.(2009). Overview of Contraception. Available at http://www.uptodate.com.
Sokol, R. J., Martier, S. S., Ager, J. W. (2008). The T-ACE questions: Practical prenatal detection of risk drinking. American Journal of Obstetrics and Gynecology, 160(4)
Russel, M. (1994). New assessment tools for risk drinking during pregnancy. Alcohol Health and Research World, 18(1)