Patient Story: Catch Fish, Not Buzz

By Jonathan Zarov —

A Wisconsin healthcare setting began delivering services this year with the help of WIPHL’s Agency for Healthcare Research and Quality (AHRQ) grant. One of their health educators tells this story…  (Some details have been changed to protect patient confidentiality.)

Screening:

The patient indicated he had consumed 5 or more drinks in a day on multiple occasions over the course of the past year on the Healthy Lifestyles Questionnaire.  I was alerted to this screening result and met with the patient.

Brief assessment and initial brief intervention:

The patient stated that he enjoyed drinking beer daily and tended to drink beer all day long when fishing on the weekends.  He typically goes fishing every weekend during the summer months. Upon brief assessment, this patient’s drinking fell into the category of harmful use.  He typically drank about 8 beers after work during the week and about 20 beers daily on weekends when fishing.

The patient expressed some desire to cut back on his alcohol use. He stated that he often felt tired. He has a young son and wants to be more active with him and his wife. I shared feedback and recommendations with him and discussed several strategies for cutting back. He agreed to try some of these out and to meet again for a follow-up visit.

Follow-up:

One week later I saw the patient for a follow-up visit. He had tried non-alcoholic beer in place of regular beer over the weekend while fishing. His friends gave him a hard time, but he said it didn’t really bother him. He noticed an increase in his energy levels and was pleased with that.  He didn’t really enjoy the taste of the non-alcoholic beer as much as regular beer, but was going to try some other brands.

A few weeks later, I followed up further with the patient. He had not had any alcohol in the previous week.  Prior to that there had been a night when he drank “quite a few” beers following a stressful event.  He had a headache and a hangover the following day. This episode influenced his decision to take a break from drinking altogether. He shared that he had been feeling “better” and “wide awake” since he stopped drinking and had been busy doing yard work instead of drinking in the evening. He had also begun eating more regular meals and looking forward to waking up early on the weekends to go fishing. He expressed concern for the upcoming weekend. He told me a lot of his friends would be around for a big fishing tournament, people who he hadn’t seen since making changes to his alcohol status, and he would want to drink with them. After we talked things over, he created a plan for how he wanted to handle this situation.

In a subsequent followup after his fishing tournament weekend, the patient shared that he had drunk more than the  low-risk drinking guidelines on one of the days, but still drank less than he would have in previous years.  He was proud of his successful efforts to decrease his alcohol use.

Overall, he has seen positive effects to his health and wellness, increased productivity levels, and an improved relationship with his wife and son. He also now sees that he can have fun fishing with his friends even when he isn’t drinking.



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