Alcohol Symposium: Diagnosis and Treatment of Alcohol Problems Flashcards
What are the effects of low doses of alcohol?
Euphoria, reduced anxiety, relaxation, sociability
What are the effects of high doses of alcohol?
Intoxication
Impaired attention and judgement, unsteadiness, flushing, nystagmus, mood instability, disinhibition, slurring, stupor, unconsciousness
What is intoxication?
The pathological state produced by a drug, serum, alcohol, or any toxic substance; poisoning
What are the terms used for diagnosis of alcohol use?
Acute intoxication
Harmful use
Dependence
Withdrawal state
What is harmful use?
Pattern of use causing damage to physical or mental health
Use >1 month or repeatedly over 12 months
What is dependence?
3 or more of the following for >1month or repeatedly over 12 months:
- Cravings/compulsions to take
- Difficulty controlling use
- Primacy
- Increased tolerance
- Physiological withdrawal on reduction/cessation
- Persistence despite harmful consequences
What is a withdrawal state?
Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance
What are the symptoms of an alcohol withdrawal state?
Tremor Weakness Nausea and vomiting Anxiety Seizures Confusion Agitation Death Delirium Tremens
What is delirium tremens?
- Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
- Mortality in DTs = 5%
- Death: cardiovascular collapse, infection, hyperthermia, seizures or self injury
- Usually 48-72 hours after alcohol stopped
How does alcohol affect mental health?
Anxiety Depression Sleep disruption Morbid Jealousy Alcoholic hallucinosis Deliberate self-injury Suicidal thoughts/acts
How does alcohol affect physical health?
Accidental injury Violence Cancer - mouth, oesophagus, liver Neurological effects - fits, confusional state, Korscoff's/Wernicke's Brain damage HTN Ulcers and gastritis Increased risk of infections Pancreatitis Impotence and infertility in women
What is Wernicke’s encephalopathy?
Confusion, ataxia, opthalmoplegia, nystagmus
What is Korsacoff’s psychosis?
Prominent impairment of recent and remote memory Preservation of immediate recall No general cognitive impairment Retrograde and anterograde memory Impaired learning and disorientation May exhibit nystagmus and ataxia
What are Wernicke’s/Korsokoff’s caused by?
Caused by thiamine deficiency
- Poor intake and absorption
- Poor hepatic function
- Increased requirement for alcohol metabolism
How can alcohol affect relationships?
Aggression
Marital difficulties - Morbid jealousy
Poor parenting/neglect +/- loss of parenting rights
Loss of friendships and social supports
