Patients/clients may be uncomfortable discussing their substance use for a number of reasons. However, patients expect their healthcare providers to inquire about their substance use.

Raise the subject and ask permission to talk about substance use in a nonjudgmental way. Using an open ended questions is a great way to open the dialogue.

"Thank you for taking the time to answer the questionnaire at check-in, can we talk about your answers to the alcohol questions?"

Follow-up statements/questions can include:

• Tell me about a typical day when you drink
• How do you feel about your drinking?
• "We've talked about several issues you’ve been facing recently, can we talk for a minute about your answers to the questionnaire on alcohol use?"
• "I know that you came in today for your blood pressure. There are several factors that can affect your blood pressure. Can I ask you more about these?"