Alcohol Dependence Flashcards
What is hazardous drinking?
Pattern of. alcohol consumption which increases someone’s risk of physical, mental and possibly also social harm
consumption of 14-35 units per week for females and 14-50 units per week for males
What is harmful drinking?
Pattern of alcohol consumption which is causing mental or physical damage
consumption of >35 units a week for women or >50 units a week for men
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
a person who is alcohol dependence may persist in drinking despite harmful consequences
What factors can influence whether a person will develop alcohol dependence?
Prolonged alcohol consumption Personality Traits Genetic factors Socioeconomic and employment factors ethnicity culture religion
What are the acute physical manifestations of alcohol dependence?
Accidents/injury acute alcohol poisoning aspiration pneumonia oesophagitis mallory Weiss syndrome gastritis pancreatitis cardiac arrythmias cerebrovascular accidents neuropraxia myopathy hypoglycaemia
What are the cutaneous and superficial signs which are suggestive of alcohol misuse?
Spider nave telangiectasia Facial mooning parotid enlargement palmar erythema dupuytren's contracture gynaecomastia
What are the possible long-term consequences of alcohol dependency of the brain?
dementia Wernicke-korsakov syndrome cerebellar atrophy marchiafava-bignami syndrome central pontine myelinolysis
What are the possible long-term consequences of alcohol dependency of the cardiovascular system?
Hypertension
cardiomyopathy
coronary heart disease
cerebrovascular accidents
What are the possible long-term consequences of alcohol dependency of the gastrointestinal system?
Oesophagitis gastritis malabsorption malnutrition liver damage (steatosis, hepatitis, cirrhosis)
Other than the effects on the brain, gastrointestinal and cardiovascular systems, what are the possible long-term consequences of alcohol dependency of the body?
Peripheral neuropathy myopathy osteoporosis skin disorders alcohol related malignancy sexual dysfunction infertility
How can alcohol misuse affect employment?
Absenteeism inefficiency in the work place impaired work performance accidents in the workplace unemployment
How can alcohol misuse affect interpersonal relationships?
Relationships often suffer with spouses/children feeling that the person is more interested in drinking than in them
domestic discord and violence associated with alcohol misuse
can cause behavioural difficulties and poor school performance in children
How can alcohol misuse affect a person’s relationship with the law?
Associated with increased criminality with offences such as underage drinking, drunk and disorderly, drink-driving, theft, burglary, violence, sexual crimes
Describe the relationship between alcohol and. psychiatric illness?
Alcohol problems and major psychiatric illness can co-exist.
In some cases the alcohol use predates and often causes the psychiatric illness
In other cases the alcohol use is a result of an. attempt to self-medicate a pre-existing psychiatric illness
What is the effect of alcohol on cognition?
Cognitive decline especially in abstract problem solving, visuospatial and visual learning and perceptual motor skills
There is often cerebral atrophy with alcohol misuse. What regions of the brain are mostly affected?
Frontal cortex
cerebellum
hypothalamus
Most patients with alcohol dependence can be treated as out patients. T/F?
True
Abstinence rather than controlled social drinking is the preferred goal for individuals with alcohol dependence. T/F?
True
Brief psychological interventions can be used in the treatment of patients with alcohol dependency. By the end of the interview what should be achieved?
Patient has clear understanding of why their drinking is of concern and the risk of continued drinking
Formulated clear goals and identified means for. change within a decided time frame
Come up with strategies to achieve this and to overcome potential barriers to change
How can CBT be used for. patients with alcohol dependency?
The individual learns to identify triggers to. drinking and to find new ways of coping with them
What is the most common drug used against alcohol dependency?
Disulfiram
Disulfiram is used in alcohol dependency. What is the mechanism of. action of disulfiram?
Inhibits hepatic ALDH
What are the effects of disulfiram if a patient consumes alcohol?
Flushing reaction, nausea, vomiting, tachycardia, hypotension, dyspnoea, dizziness, headache
Naltrexone can be used in alcohol dependency. What is the mechanism of action of naltrexone?
Opiate receptor antagonist
Naltrexone works best in patients who are already abstinent. T/F?
True
Acamprostate can be used against alcohol dependency. What is the mechanism of action of. acamprostate?
Glutamate antagonist
Acamprostate has a excellent safety profile. T/F?
True
What are the NHS recommenced safe drinking levels?
Maximum of 14 unfits a week, ideally. spread over three days or more especially if drinking as much as 14 units per week
What level of blood alcohol is allowed for driving in Scotland?
50mg/100ml of blood
Alcohol levels permitted for driving are lower in Scotland than the rest of the UK. T/F?
True
What are the stages in the process of change?
Contemplation Preparation Action Maintenance Either Permanent change or Relapse
What is meant by the stage of precontemplation?
The stage where the person is not yet considering the possibility of change
What are the stages of an alcohol brief intervention?
Raising the issue of alcohol
Screening and giving feedback
Listening for readiness to change
Selecting an approach
What approach should be used for a patient in the precontemplation stage?
Information and advice
What approach should be used for a patient in the contemplation stage?
Understanding and motivation
What approach should be used for a patient in the preparation stage?
Give patient menu of choices
What approach should be used for a patient in the action stage?
Build confidence
What approach should be used for a patient in the maintenance stage?
Coping strategies
