Alcohol Use Disorder Flashcards
How much ml wise is 1 unit of alcohol?
10mls
How many grams are in 1 unit of alcohol?
8
How many units are recommended by WHO per week?
14
What is considered binge drinking?
8 units in one sitting
How many of patients admitted to hospital are at risk of alcohol withdrawal?
8%
How many people drink at hazardous or harmful levels?
1 in 4
What is hazardous drinking?
A pattern of alcohol consumption that increases the risk of harmful consequences for the user
Drinking more than 14 units a week but less than 35 (women) or 50 (men)
What is harmful drinking behaviour?
A pattern of alcohol consumption that is causing mental or physical damage
More than 35 units for women
More than 50 units 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
What is the DSM 5 criteria for alcohol use disorder?
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following occuring at any time in the same 12 month period:
Alcohol taken in larger amounts over a longer period than intended
Persistent desire or unsuccessful efforts to cut down
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects
Craving or strong desire to use alcohol
Results in failure to fulfill major obligations
What is the definition of tolerance?
Need for markedly increased amounts of alcohol to achieve intoxication or desired effect
Markedly diminished effect with continued use of the same amount of alcohol
What is the definition of withdrawal?
Characteristic withdrawal syndrome for alcohol
Alcohol (or closely related substance such as BZD) is taken to relieve or avoid withdrawal
What is mild alcohol use disorder?
Presence of 2-3 symptoms
What is moderate alcohol use disorder?
Presence of 4-5 symptoms
What is severe alcohol use disorder?
Presence of 6 or more symptoms
What is AUDIT?
Alcohol Use Disorders Identification Test
Comprehensive 10 question alcohol harm screening tool
What are the 5 elements of alcohol dependence?
Physical withdrawal Affective withdrawal Withdrawal relief drinking Alcohol consumption Rapidity of reinstatement
What is the CIWA-AR?
Clinical Institute Withdrawal Assessment for Alcohol
Ten item scale used in the assessment and management of alcohol withdrawal
What is included in the FRAMES model for brief intervention?
Feedback; review problems experienced because of alcohol
Responsibility; patient is responsible for change
Advice; adviese reduction or abstinence
Menu; provide options for changing behaviour
Empathy; use empathic approach
Self-efficacy; encourage optimism about changing behaviour
What are the stages of change?
Precontemplation contemplation Planning Action Maintenance Relapse Then back to precontemplation
What are the 4 central principles of motivational interviewing?
Express empathy by using reflective listening to convey understanding
Develop discrepancy between most deeply held values and current behaviour
Sidestep resistance by responding with empathy and understanding rather than confrontation
Support self efficacy by building confidence that change is possible
Psychosocial interventions to prevent relapse?
CBT
Motivational enhancement therapy
AA
Family and couple therapy
What drug is used for medically assisted detoxification?
Chlordiazepoxide
Symptoms of alcohol withdrawal syndrome?
Tremor, sweating, nausea, retching Increased HR, BP, T Anxiety, agitation Insomnia, nightmares Auditory, visual and tactile hallucinations Withdrawal seizures Delirium tremens
What is the time scale for withdrawal seizures?
0-48 hours
What is the time scale for delirium tremens?
48-72 hours
Symptoms of DTs?
Coarse tremor
Confusion
Delusions
Hallucinations
What nTs drive alcohol withdrawal syndrome?
Low GABA
High glutamate
What constitutes a complicated withdrawal?
Seizures
Hallucinosis
DTs
Wernicke-Korsakoff syndrome
What are the licensed drugs in the UK to prevent relapse?
Acamprosate
Naltrexone
Disulfiram
Mode of action of acamprosate?
Action on GABA and glutamate transmission, correct the nT imbalance post withdrawal and reduces craving
Mode of action of naltrexone?
Blocks opioid receptors
Reduce rewarding effect mediated by endorphin system
Mode of action of disulfiram?
Anticraving via increased dopamine transmission
Psychological deterrent
Inhibits aldehyde dehydrogenase
