Alcohol and Substance Misuse

Question 1

What are the new guidelines for the safe limits of alcohol consumption for men and women within one week?

Answer 1

14 units a week.

Question 2

How much alcohol can pregnant women drink?

Answer 2

None at all.

Question 3

How do you calculate the units of alcohol?

Answer 3

Amount X Percentage / 1000

Or the percentage in 1 litre

Question 4

What is hazardous drinking?

Answer 4

A pattern of alcohol use that increases someone’s risk of harm - physical and mental health.

Question 5

What is harmful drinking?

Answer 5

A pattern of alcohol use that is causing mental and physical damage.

Question 6

What is alcohol dependence?

Answer 6

A cluster of behavioural, cognitive and psychological factors that typically include a strong desire to drink alcohol and difficulties in controlling its use.

Question 7

What are the criteria for alcohol dependence in the ICD 10 and how many do you need to have to be diagnosed?

Answer 7

1. Strong desire or compulsion to drink
2. Difficulty in controlling drinking
3. Withdrawal state or use of alcohol to avoid withdrawal
4. Tolerance
5. Neglect of alternative interests
6. Continued use despite harmful consequences

3 or more

Question 8

What is the CAGE questionnaire for, what are the questions and how many positive responses present a problem?

Answer 8

A screening tool for alcohol problems.

Have you tried to Cut down?
Do you get Annoyed when asked about drinking?
Do you feel Guilty of your drinking habit?
Do you feel the need to drink alcohol in the morning? Eye opener.

2 positive responses, explore further.

Question 9

What is the short term biological intervention for alcohol intoxication?

Answer 9

1) Oral thiamine and vitamin B
2) If suspicion of Wernicke’s encephalopathy parenteral vitamins
3) Detoxification with Chlordiazepoxide (benzodiazepine) 20-30mg qds - reducing regime over 5-7 days (use Lorazepam in severe liver disease)

Question 10

What are the long term biological interventions for alcohol dependence?

Answer 10

1) Disulfiram 200mg od aversive agent
2) Acamprosate 666mg tds anticraving agent
3) Naltrexone 50mg od anticraving agent

Question 11

What are the short term psychological interventions for alcohol dependence?

Answer 11

1) Simple counselling and advice

2) Motivation Interviewing

Question 12

What are the long term psychological interventions for alcohol dependence?

Answer 12

Relapse prevention strategies by behavioural therapies.

1) CBT
2) Social network and behavioural therapy

Question 13

What are the short and long term social interventions for alcohol dependence?

Answer 13

Short - Support with accessing services, housing etc.

Long - Alcoholic anonymous, rehabilitation