Alcohol Misuse Disorder

Question 1

what is hazardous drinking

Answer 1

pattern of consumption that increases risk of harmful consequences

not a diagnostic term

> 14 units per week but <35 for women and <50 for men

Question 2

what is harmful drinking

Answer 2

pattern of alcohol consumption causing mental or physical damage

> 35 units a week or more for women

> 50 units a week for men

Question 3

what is alcohol dependance

Answer 3

cluster of behavioural, cognitive and physiological factors typically including a strong desire to drink alcohol and difficulties in controlling its use

Question 4

what is the DSM 5 criteria for alcohol use disorder

Answer 4

maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by 2 or more of the following occurring in 12 months:

• alcohol taken in larger amounts over a longer period than intended
• persistent desire or efforts to cut down/control
• great amount of time spent in activities necessary to obtain/use/recover from the effects of alcohol
• craving or a strong desire or urge to use alcohol
• recurrent use resulting in failure to fulfil major role obligations (work, school, home)
• continued use despite recurrent problems caused by it
• important social, occupational, or recreational activities given ip bc alcohol use
• recurrent alcohol use in situations which it is physically hazardous
• use continued despite knowledge that there is a problem

Question 5

DSM 5 criteria for a mild alcohol use disorder

Answer 5

presence of 2-3 symptoms

Question 6

DSM5 criteria for a moderate alcohol use disorder

Answer 6

presence of 4-5 symptoms

Question 7

DSM 5 criteria for severe alcohol disorder

Answer 7

presence of 6 or more symptoms

Question 8

what is the AUDIT

Answer 8

alcohol use disorders identification test

comprehensive 10 q question alcohol harm screening tool

Question 9

what does the severity of alcohol dependence questionnaire measure

Answer 9

Physical withdrawal 
Affective withdrawal 
Withdrawal relief drinking 
Alcohol consumption 
Rapidity of reinstatement

Question 10

what is a brief intervention

Answer 10

FRAMES

• feedback - review problems
• responsibility - accept responsibility for change
• advice - advice reduction or abstinence
• menu - provide options for changing behaviour
• empathy - use empathetic approach
• self efficacy - encourage optimism about changing behaviour

Question 11

what psychological interventions can be used for relapse prevention

Answer 11

CBT
Motivational enhancement therapy
12 step facilitation therapy (AA)
Family and couple therapy

Question 12

what drug is used for medical detoxification

Answer 12

Chlordiazepoxide

Question 13

what are some problems with using chlordiazepoxide

Answer 13

high rate of relapse after successful medical withdrawal

cognitive impairment, cumulative neuronal damage

severity of withdrawal symptoms increases after each withdrawal

Question 14

how does alcohol withdrawal syndrome present

Answer 14

Tremor, sweating, nausea, retching
Increased HR, BP, T
Anxiety, agitation
Insomnia, nightmares
Auditory, visual, tactile hallucinations
Withdrawal seizures
Delerium tremens (48-72) coarse tremor, confusion, delusions, hallucinations

Question 15

what are some symptoms of complicated withdrawal

Answer 15

Seizures
Hallucinosis
Delirium tremens
Wenicke-korsakoff syndrome

Question 16

what drugs are used for relapsed prevention after withdrawal

Answer 16

Acamprosate (corrects neurotransmission imbalance)
Naltrexone (Blocks opioid receptors)
Disulfiram (anti craving - causes an unpleasant reaction if taken with alcohol