Ask him for details of his substance use

“Tell me a bit more about your alcohol/drug use. When did you begin using? What is your use like now?”

He checks again that the conversation is confidential. Once you reassure him, he reports that he and his friends drink most Friday and Saturday nights. He started earlier this year because one of his new friends has access to alcohol from his older brother. He denies any blackouts and they always drink at a friend's house. He has been given a ride home a couple of times when they have been drinking.

He also uses marijuana once or twice a week. He shares a couple of joints with a friend. He is not convinced marijuana is a problem & states that "people overreact". He doesn't think it is addictive because he only smokes occasionally & doesn't crave it. However, he does admit that he uses the marijuana to relax especially when he is feeling stressed about stuff at home.