Addictive Behaviour SDL Flashcards
Define hazardous drinking
a level of drinking that increases the risk of harmful consequences for the user
- drink over the receommnede limbs,
- have so far avoided significant alcohol-related problems
Define harmful drinking
drinking at a level leading to physical, social or psychological harm
Define alcohol dependence
3 or more of a range of symptoms including: tolerance, withdrawal, craving, relief of withdrawal, neglect of alternative pleasures, persistence despite consequences
How is the amount of alcohol in a drink calculated?
volume X ABV / 1000
What are the recommend alcohol limits in the UK?
- no safe amount
- no more than 14 units a week
Define binge drinking
excessive consumption of alcohol over a short period of time
What factors can cause alcoholism?
- > 12/15 drinks a week
- more than 5 drinks a day
- parent with alcoholism
- coexisting mental health problems
- young adult, peer pressure
- low self esteem
- high stress levels
- alcohol accepted culture
- close relative with alcoholism
Patient comes in early in the morning smelling of alcohol. What should you do? What treatment options are available?
- talk to him about it
- suggest to book another appointment
- refer to nurse
- questionnaires e.g. AUDIT
- make patient make first AA appointmnet
- do blood tests, gammaGT, ATT, ALT, CRP
Give 5 medical harms associated with hazardous and harmful use of alcohol
- injuries
- GI conditions
- cancer
- CVS disease
- pre-natal harm
Give 5 social harms associated with hazardous and harmful use of alcohol
- marital harm
- social nuisances
- child abuse
- crime/violence
- homocide
How can you identify hazardous and harmful alcohol use?
- measuring alcohol use
- screening instrument
What does AUDIT stand for?
What was it designed for?
What is the format of it?
- Alcohol Use Disorder Identification Test
- Designed to detect at-risk, harmful or heavy drinking
- 10 questions covering the three domains of hazardous alcohol use, alcohol dependence and harmful alcohol use. Scored from 0-4, total score calculation
Users normally respond better to audit when: - - - - -
- the person conducting the interview is friendly and not threatening
- the aim of the question is clearly related to diagnosing the users state of health
- the user does not consume alcohol or drugs whilst the selection is made
- the information is considered to be confidential
- the questions are easy to understand
What AUDIT score suggest a potential problem?
What items suggest harmful alcohol consumption?
What items suggest the beginnings of dependency?
8 or above
7-10
4-6
What are the shortened versions of AUDIT?
- AUDIT
FAST (fast alcohol screening test) - 5 shot questionnaire
Why are biochemical tests for alcohol use disorders such as liver enzymes and MCV not useful for screening?
poor sensitivity, only identify a small proportion of patents with hazardous or harmful alcohol consumption
People drink in order to obtain certain advantages and it becomes a problem when:
- alcohol does not obtain the advantages that the person sought initially e.g. confidence, relaxation,
- longer term adverse consequences
What might be the barriers to implementing the brief intervention approach?
- may require too much time
- inadequate training related to screening and counselling
- antagonising patients over a sensitive issue –> anger
- assumption that alcoholics do not respond to primary care interventions
List the steps involved in brief intervention
- introduce and indemnity that they are high risk-
- explain health risks, give leaflet
- show panel 3 and risks
- discuss the need to stop or cut down
- discuss sensible limits
- what is a standard drink?
- conclude with encouragement
- be empathetic, non-judgemental, authoritative, deflect denial, facilitate and follow up
What are the questions in the CAGE questionnaire?
- have you ever felt you should Cut down?
- have you every felt Annoyed when people criticise your drinking?
- have you have felt Guilty about your drinking?
- have you ever had a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?
