D is a 55-year-old retired Air Force pilot with chronic back problems and no other medical issues. You have seen him for routine care several times over the past couple of years. He drinks wine most evenings, consuming a bottle at dinner, sometimes more; at cocktail parties, which he attends at least weekly, he will have 2-4 cocktails. Although drinking is a significant part of his life, he has never experienced personal, social, or medical problems due to it. His wife drinks about half as much as he does, just as regularly. He has never tried to cut down on his drinking. The rest of his CAGE assessment is negative. His AUDIT score is 10-12 based on questions 1-3, with other questions scoring 0. His liver function tests (LFTs), mean corpuscular volume (MCV), and other routine blood work are normal. Over the two-year period, you have revisited the AUDIT questions several times, and his answers have never varied. His wife confirms his heavy drinking without problems. You have advised him to reduce his intake to the NIAAA "safe" level (not more than 4 drinks per day, and not more than 15 drinks per week). He has stated he will consider it but has not made any changes in the past two years. Your diagnosis is hazardous drinking, but you remain concerned about alcohol abuse or even dependence, making your diagnosis tentative. What do you now recommend or advise?

A) Discuss the pros and cons of his drinking behavior and see if you can encourage some contemplation about change.

B) Assess his understanding of the health risks associated with the quantity he is drinking, and offer to discuss his beliefs where his knowledge is deficient.

C) Repeat your recommendations about adhering to safe drinking levels.

D) Do not discuss the issue since the patient does not express an interest in changing his behavior.