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En el caso de los consultantes de 9 a 11 años, todo consumo será de ALTO RIESGO. En el caso de los consultantes que consuman alcohol, dentro de los grupos entre 11-14 años y entre 14-18 años, usted requerirá continuar con un segundo paso, para interpretar las respuestas del consultante y definir el nivel de riesgo del consumo.\\n\\nComo un indicador general del nivel de riesgo del consultante, use la tabla de abajo. \\n\\n\\n\\n\\n\\n\\n\\nHaga clic sobre miniatura para ampliar tabla\\n\\nEn la tabla, revise donde la edad de su consultante y la frecuencia de consumo se intersectan: Si su consultante responde a la pregunta de evaluación con una frecuencia de consumo por mes o una frecuencia por semana (cuántas veces al mes / cuántas veces a la semana), convierta la respuesta en días aproximados por año, para aplicar esta tabla. Por ejemplo, si un joven de 15 años dice beber dos veces al mes aproximadamente, eso equivale a 24 días en el año, lo que sitúa al adolecente en el nivel de ALTO RIESGO.\\n\\nLas intervenciones, luego, corresponden a los 3 niveles de riesgo: BAJO RIESGO, RIESGO, ALTO RIESGO.\\n\\nEn relación con el consumo de alcohol de amigos y otros factores de riesgo, haga más preguntas si es necesario, y aplique su juicio clínico para determinar mejor el nivel de riesgo. Algunos factores relacionados con el consumo en amigos/as:\\nPara consultantes de educación básica: Tener amigos/as que beben es altamente preocupante. Ya que tener amigos/as que consumen alcohol significa un riesgo mayor, pregunte cuántos amigos/as beben, si el consultante aún no le ha dado esta información.\\nPara consultantes de educación media: Tener amigos/as que se emborrachan es altamente preocupante (consumo excesivo episódico: alta cantidad de alcohol en poco tiempo, un mismo día u ocasión de consumo). Recientes estudios estiman que los niveles de emborrachamiento o consumo excesivo para adolescentes comienzan entre los 3 y los 5 tragos, dependiendo de la edad y el sexo.\\n\\nPor último, incluya en la evaluación lo que ya sabe acerca del desarrollo físico y psicosocial del consultante, en la evaluación que realice, junto con otros factores relevantes como el nivel de apoyo familiar, hábitos de consumo de alcohol y tabaco en los \\n\\n\\nMás información\\n\\nSi usted quiere o necesita información más completa y detallada acerca del CRAFFT, le sugerimos los siguientes documentos: \\n\\nMinisterio de Salud (2015). Orientaciones técnicas para la detección, intervención motivacional y referencia a tratamiento para el consumo de alcohol y otras drogas en adolescentes. Santiago: Ministerio de Salud.\\nDisponible en: \\nhttp://web.minsal.cl/wp-content/uploads/2015/09/OT-Detecci^%^C3^%^B3n-IM-y-referencia-drogas-adolescentes.pdf\\n \\nNational Institute on Alcohol Abuse and Alcoholism (2015). Alcohol screening and brief intervention for youth. A practitioner’s guide. \\nDisponible en: 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En cualquier instrumento, 1 punto o más  será indicador de CONSUMO DE RIESGO durante el embarazo y el puerperio. El uso de estos instrumentos durante el embarazo puede tener limitaciones, pues en ocasiones el auto-reporte del propio consumo de alcohol y otras drogas en el embarazo posiblemente esté subestimado, a veces por el efecto de lo socialmente deseado o por temor de las mujeres de aceptar sus consumos ante profesionales de salud.\\n\\nEn cualquier caso, el uso de los instrumentos conocidos puede ser orientador y las respuestas en cada ítem o pregunta pueden servir para caracterizar el consumo de una consultante, así como también para evaluar el grado de compromiso o gravedad del consumo. \\n\\nAhora bien, si usted no está seguro/a de la evaluación del consumo de alcohol y/o otras drogas en una mujer embarazada o en puerperio, complementaria a AUDIT-ASSIST-CRAFFT, un instrumento que puede ser muy útil es el 4P’s PLUS (Chasnoff et al, 2007).\\n\\nLos contenidos han sido traducidos y adaptados en el caso de algunas nominaciones y situaciones de contexto, para hacerlos aplicables y coherentes con nuestra práctica, pero no se ha realizado un proceso de validación del método para la población en Chile.\\n\\nDescargue e imprima el CUESTIONARIO 4P’s PLUS “Instrumento 4Ps PLUS”.\\n\\nUna de las mayores propiedades de este instrumento es indagar de manera simple - en 1 o 2 minutos - sobre cuatro categorías, dentro de las cuáles solo la primera se refiere al consumo durante el embarazo. De esta manera, una consultante estará más dispuesta a hablar del tema sin temor al rechazo y juicios que puedan hacerse respecto de un potencial consumo. \\n\\nLas categorías son: consumo problema de los padres, el consumo problema de la pareja, el consumo pasado de la consultante, el consumo presente de la consultante.\\nSe ha encontrado asociación potencial entre un consumo problemático de alcohol en padres y/o pareja con una mayor posibilidad de uso de alcohol durante el embarazo, en la mujer. También se ha encontrado que una asociación entre consumo pasado y mantención del consumo durante el embarazo y/o puerperio. \\n\\nDe esta manera, es posible aproximarse a una sospecha de consumo de alcohol durante el embarazo o puerperio, un riesgo, sin indagar directamente sobre el consumo actual. 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Deben buscarse entonces otros métodos clínicos de confirmación, pero sí se debe considerar el consumo como un potencial RIESGO. Se recomienda, si usted NO ESTÁ SEGURO/A O TIENE DUDAS acerca del consumo de alcohol y/o drogas en una consultante embarazada - y si los recursos del establecimiento de salud lo hacen posible - que haga una REFERENCIA ASISTIDA para una mejor evaluación.\\n\\nTenga en consideración que la detección de consumo de drogas psicoactivas mediante exámenes de laboratorio a mujeres en el embarazo o puerperio no necesariamente indica el tipo de consumo ni orienta la conducta a seguir, por lo que no se recomienda realizarlo. Además, si usted condiciona la atención de salud a la realización de este tipo de exámenes, si de alguna manera obliga, puede poner en riesgo la relación que está construyendo con su consultante.\\n\\nPor último, siempre recuerde que instrumento solo permite definir una sospecha, pero no califica como evidencia o documentación de consumo de alcohol durante el embarazo. No asuma que la consultante consume alcohol o drogas (en las tres primeras preguntas), sino que solamente ella se encuentra en riesgo. Siempre use este instrumento de manera complementaria a los otros recomendados: AUDIT, ASSIST, CRAFFT.\\n\\n\\nMás información\\n\\nSi usted quiere o necesita información más completa y detallada acerca de la evaluación del consumo de alcohol y otras drogas durante el embarazo y el puerperio, le sugerimos los siguientes documentos: \\n\\nMinisterio de Salud (2019). Cómo enfrentar el consumo de tabaco, alcohol y otras drogas en el embarazo y puerperio. 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