alcohol and drug addiction Flashcards
UK guidelines for drinking
low risk- 14 units/week
increased risk- 15-35 units/week
higher risk- regularly drinking >35 units/week
alcohol dependence syndrome
strong desire/compulsion to take drug, withdrawal state, evidence of tolerance
Lab testing for alcohol dependence
GGT- liver injury
carbohydrate deficient transferin- identifies men drinking >5units a day for 2 weeks/more
Most common cause of increased MCV
alcoholism
Brief interventions alcohol
duration of intervention- 15-25 mins- adults identified using screening
FRAMES approach for alcohol
Feedback Responsibility Advice Menu- provide options for change Empathy Self efficacy- encourage optimism about changing behaviour
next steps after brief intervention for alcohol use
Detoxification- relapse prevention and alcohol withdrawal
relapse prevention for alcohol use
psychosocial and pharmacological interventions aimed at maintaining abstinence
Alcohol withdrawl
excess glutamate activity, decreased GABA, toxic to nerve cell. Acute withdrawal- CNS excitatability and neurotoxicity
1st symptoms- within hrs and peak at 24-48hrs- tremor, N&V, tachycardia, sweating etc
Generalised seizures and delirium tremens can occur in 1st 24hrs
management of alcohol withdrawal
general support
benzos
vitamin supplementation- parenteral (?pabranex)- prophylaxis against wernickes encephalopathy
alcohol withdrawal timeline
symptoms- 6-12hrs
seizures- 36hr
delirium tremens- 72hrs
wernickes encephalopathy
thiamine deficiency
triad of ophthalmoplegia, confusion and ataxia
visual impairment, hearing impairment, impaired concious level, hypothermia, lactic acidosis, circulatory changes
One of the main aims with substance abuse
harm reduction- prevent IVDUs from getting HIV
medical interventions for substance abuse
Replacement prescribing (methadone, buprenorphine), detoxification, relapse prevention, benzos
detoxification of optiates
selected patients- shorter history, relatively stable socially
