For some people, referral to more specialist help is the most appropriate course of action. People identified as being alcohol dependent – those with an AUDIT score of 20 or more, or showing signs of alcohol dependence – should be referred, as should people with severe alcohol-related problems such as losing their job, or alcohol-related harm such
as accidents. 

A person identified as an increasing or higher risk drinker may also ask to be referred for further support. It is increasingly common for specialist services to take referral directly from healthcare professionals. Where possible, a community pharmacy professional should make a direct referral to specialist services, with the individual’s permission.

Practice points

• What symptoms might people present with in the pharmacy that could indicate they may benefit from a discussion about their alcohol intake?
• How would you bring this up with the individual?
• What do you think are the most common reactions from people when they are approached about their drinking habits? How would you respond?