West Virginia University School of Medicine, Charleston sfields@hsc.wvu.edu
The authors reported no potential conflict of interest relevant to this article.
A full biopsychosocial interview is key, including use of an efficient tool such as the S2BI questionnaire, to quickly stratify risk level and to guide follow-up decisions.
Paul F* is a 16-year-old White boy who lives with his mother and spends some weekends with his father who has shared custody. He recently presented to the clinic for treatment due to an arrest for disorderly conduct at school. He and a friend were found drinking liquor outside the school building when they were scheduled to be in class. Paul reported that he and his friends often drink at school and at extracurricular functions. He has been using alcohol for the past 2 years, with escalating consumption (5 or more drinks per episode) in the past year. Paul has been drinking most days of the week and has even driven under the influence at times. He said, “I just feel happier when I am drinking.” An accomplished soccer player recruited by colleges, Paul recently was suspended from the team due to his poor grades. His response was, “It’s stupid anyway. What’s the point of playing?”
● How would you proceed with this patient?
* The patient’s name and some personal details have been changed to protect his identity.
