Alcohol Addiction Flashcards
What is 1 unit of alcohol equivalent to?
10mls (8g)
How much alcohol was sold in Scotland in 2017?
46 million litres (19.6 units/week/adult)
How many people drank harmful/hazardous levels?
1 in 4
What is hazardous drinking?
A pattern of alcohol consumption that increases the risk of harmful consequences
What is the range of hazardous drinking in women?
> 14 units per week, but <35 units per week
What is the range of hazardous drinking in men?
> 14 units a week, but <50 units a week
What is harmful drinking?
A pattern of alcohol consumption that is causing mental or physical damage
What is classed of harmful drinking in men and women?
50 units per week or more a week for men
35 units per week or more for women
What is alcohol dependence?
A cluster of behavioural, cognitive and physiological factors that typically include a strong desire to drink alcohol and difficulties in controlling its use
What does the DSM-IV describe?
Two distinct disorders, alcohol abuse and alcohol dependence, with specific criteria for each
What does the DSM-V describe?
It integrates the two disorders into a single disorder called Alcohol Use Disorder (AUD)
What are the ranges of AUD?
Mild, moderate or severe
What is the AUD Identification Test (AUDIT)?
Comprehensive 10 question alcohol harm screening tool developed by WHO
What score on the AUDIT indicates alcohol dependence?
20 or more
What five elements does the Severity of Alcohol Dependence Questionnaire assess?
Physical Withdrawl, Affective Withdrawl, Withdrawl Relief Dependence, Alcohol Consumption and Rapidity of Reinstatement
What does CIWA-AR stand for?
Clinical Institute of Withdrawl Assessment for Alcohol
What is the CIWA-AR?
Ten item scale used in the assessment and management of alcohol withdrawl
What is the maximum score in the CIWA-AR?
67
What is Chlordiazepoxide?
Drug of choice for medical assisted detox (well tolerated)
What are the problems associated with Chlordiazepoxide?
High rate of relapse after successful medical withdrawl
Cognitive impairment and cumulative neuronal damage
Kindling effect = severity of withdrawl symptoms tends to increase after each alcohol withdrawl
What are some features of a complicated withdrawl?
Seizures, hallucinations, Delirium Tremens, Wernicke-Korsakoff Syndrome
How do you prevent some of the features of a complicated withdrawl?
Give vitamin B12 before the withdrawl is started
When is relapse prevention started?
After a successful withdrawl
What are some relapse prevention drugs licensed in the UK?
Acamprosate, Naltrexone and Disulfiram
What are some relapse prevention drugs licensed in Europe?
Sodium Oxybate (Italy), Baclofen (France)
What is Acamprosate?
Drug first licenced in France in 1989 for the prevention of relapse
How does Acamprosate work?
Acts on GABA and Glutamate transmission. Corrects the neurotransmission imbalance post withdrawl and reduces craving
What is Naltrexone?
Drug first licensed in UK in 2012 for alcohol treatment
How does Naltrexone work?
Blocks opioid treatment and reduces rewarding effect mediated by endorphin system
How does Disulfiram work?
Alcohol and Disulfiram cause an unpleasant reaction (psychological deterrent) and has an anti-craving effect through increased dopamine transmission
What are some problems with Disulfiram?
Potential rare but severe side effects and low compliance
What are some unlicensed drugs used to prevent relapse prevention?
Topiramate and Gabapentin
