Alcohol dependence

Question 1

Outline the NHMRC guidelines for alcohol?

Answer 1

No more than 2 standard drinks of single occassion to reduce lifetime risk of disease or injury
No more than 4 standard drinks of any occasion to reduce injury associated with that occasion.
NO drinking less than 18 years old and pregnant women

Question 2

Outline the drug therapies available for alcohol dependence?

Answer 2

Thiamine 300mg.day
Oral multivitamin
Naltrexone reduce relapse rates by reduce cravings and reward
Acamprosate reduce craving by brain GABA and glutamate
Disulfuram causes build up of acetylaldehyde causing headache, palpitations, vomiting.

Question 3

Name 2 tools that can be used to screen for alcohol dependence?

Answer 3

AUDIT and AUDIT C tools

Provide pictorial way of guiding amount of standard drinks

Question 4

Outline how you would initiate alcohol medications?

Answer 4

Abstinence is usual goal
First line is naltrexone especially if patient is still drinking or binge drinks.
Once the patient is abstinent - use acamprosate

2nd line Disulfuram - patient needs to be abstinent.