If drinking is leading to poor health, difficulties with work, relationships, finances or with the law, or causes distress to themselves or others around them, then they may have an alcohol problem.

As for determining whether someone in the community has a problem, there are a number of tests available and the test that is used varies according to who is administering it. But generally they will be looking at the effects of alcohol on one or all of the following parameters of the persons life : Physiology, Psychology, Social and Domestic lives.

The Audit (Alcohol Use Disorders Identification Test) is one of  the most robust questionnaires for identifying someone with an alcohol problem it has been vigorously tested and shown to have around 94% sensitivity and selectivity. The questions are based on measures taken from the American DSM IV Criteria for Substance Abuse and Substance Dependence (the UK equivalent is the ICD 10) which are medical criteria for diagnosing and categorizing substance misuse problems.

Thanks to Mick Burrows and Mark Holmes (Alcohol Liaison Team, Queens Medical Centre Nottingham) for the information regarding symptoms and mechanisms of the physical and psychological effects of alcohol which have been included in the following pages.