Alcohol Use Disorder

Question 1

how much is one unit of alcohol

Answer 1

10mls/8grams

Question 2

how many units= binge drinking

Answer 2

more than 8 units in one day

Question 3

how many people admitted to hospital are at risk of alcohol withdrawal

Answer 3

8%

Question 4

how many units per week is advised

Answer 4

max 14

Question 5

how many people drink to a hazardous level

Answer 5

1 in 4 (more than 14 units)

Question 6

define hazardous drinking

Answer 6

a pattern of alcohol consumption that increases risk of harmful consequences for the user
drinking more than 14 but less than 35 (women)/ 50 (men) units per week

Question 7

define harmful drinking

Answer 7

a pattern of alcohol consumption that is causing mental or physical drinking
drinking 35/+ a week (women) or 50/+ (men) units a week

Question 8

define alcohol dependence

Answer 8

a cluster of behaviour, cognitive and physiological factors that typically include a strong desire to drink alcohol and difficulties in controlling its use

Question 9

what are the severities of alcohol use disorder

Answer 9

mild 2-3 symptoms
moderate 4-5 symptoms
severe 6+ symptoms

Question 10

what is the criteria for alcohol use disorder

Answer 10

DMS 5
a maladaptive pattern of behaviour of substance use leading to clinically significant impairment or distress- as manifested by 2+ of (occurring at same time within 12 month period):
Alcohol is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
Craving, or a strong desire or urge to use alcohol.
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is physically hazardous.
Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

Question 11

define tolerance

Answer 11

either:
a need for markedly increased amounts of alcohol to achieve intoxication or desires effect
or
a markedly diminishes effect with continued use of the same amount of alcohol

Question 12

what are the two ways withdrawal can manifest

Answer 12

characteristic withdrawal syndrome

alcohol/ closely related substance (benzodiazepine) is taken to relieve of avoid withdrawal symptoms

Question 13

name the comprehensive 10 question alcohol harm screening tool

Answer 13

alcohol use disorder identification test AUDIT

Question 14

what does the severity of alcohol dependence questionnaire measure

Answer 14

physical withdrawal 
affective withdrawal 
withdrawal relief drinking 
alcohol consumption 
rapidity of reinstatement

Question 15

what is the ‘clinical institute withdrawal assessment for alcohol’ (CIWA-AR)

Answer 15

ten item scale used in the assessment and management of alcohol withdrawal

Question 16

what do AUDIT score mean

Answer 16

0-7= lower risk drinking, reinforce current drinking problems

8-14= hazardous drinking, deliver brief intervention

15-19= harmful drinking, deliver brief intervention and motivational enhancement therapy session, consider prescribing options

20+/ DUI 15+ = possible dependence, do comprehensive assessment

Question 17

what are the components of the brief intervention

Answer 17

FRAMES
feedback (review problems)
responsibility (patient responsible for change)
advice (advise reduction or abstinence)
menu (provide option for changing behaviour)
empathy
self -efficacy (encourage optimism about changing behaviour)

Question 18

what are the four principles of motivational enhancement therapy

Answer 18

express empathy using reflective listening to convey understanding

develop the discrepancy between their most deeply held values and their current behaviour

sidestep resistance by responding with empathy and understanding rather than confrontation

support self efficacy by building confidence that change is possible

Question 19

what are the psychological interventions for relapse prevention

Answer 19

cognitive behavioural therapy
motivational enhancement therapy
12 step facilitation therapy (AA)
family and couple therapy

Question 20

what drugs are used for medically assisted detoxification

Answer 20

chlordiazepoxide

Question 21

what are the problems with chlordiazepoxide

Answer 21

high rate of relapse after successful medicated withdrawal
cognitive impairment, cumulative neuronal damage
kindling effect (severity of withdrawal symptoms tends to increase after each alcohol withdrawal

Question 22

what are the symptoms of alcohol withdrawal

Answer 22

tremor, sweating, nausea, retching
increased HR, BP and temp
anxiety, agitation
insomnia, nightmares
auditory, visual, tactile hallucinations
withdrawal seizures (0-48 hrs)
delirium tremens (48-72 hrs): coarse tremor, confusion, delusions, hallucinations

Question 23

what causes alcohol withdrawal syndrome

Answer 23

high glutamate, low GABA

Question 24

what are the features of a complicated alcohol withdrawal

Answer 24

seizures
hallucinations
delirium tremens
wernicke-korsakoff syndrome

Question 25

what drugs are licensed to prevent relapse after successful withdrawal

Answer 25

acamprosate
naltrexone
disulfiram

Question 26

how does acamprosate work

Answer 26

action on GABA and glutamate transmission: corrects the neurotransmission imbalance post withdrawal and reduces cravings

Question 27

how does naltrexone work

Answer 27

blocks opioid receptors

reduces rewarding effect mediated by endorphin system

Question 28

what are endorphins

Answer 28

endogenous opioid neuropeptides

Question 29

how does disulfiram work

Answer 29

causes and unpleasant and dangerous reaction when alcohol consumed
psychological deterrent
anticraving effect through increased dopamine transmission
potential rare but severe SEs
low compliance

Question 30

how do you calculate units

Answer 30

volume x percentage

Question 31

what mental problem can steroid cause

Answer 31

mania

Question 32

what can abscesses in IVDU lead to

Answer 32

aneuysm in femoral arteries, osteomyelitis, septic arthritis, infective endocarditis