Alcohol use disorder Flashcards
what is 1 unit of alcohol equivalent to
10ml or 8g
what is the alcohol limit for males and females per week
no more than 14 units of alcohol per week ideally spread over 3 days
how do you calculate units of alcohol
1000
define hazardous drinking
pattern of alcohol consumption that increases the risk of harmful consequences for the user
hazardous drinking is a diagnostic term, true or false
false
units of alcohol per week consumed for M+F in hazardous drinking
F: between 14-35
M: between 14-50
define harmful drinking
pattern of alcohol consumption that is causing mental or physical damage
units of alcohol per week consumed for M+F in harmful drinking
F > 35
M > 50
define alcohol dependence
behavioural, cognitive and psychological factors that include a strong desire to drink alcohol and difficulties in controlling its use
what are the diagnostic terms in DSM4
alcohol abuse
alcohol dependence
what is the diagnostic term in DSM5
mild/mod/severe
alcohol use disorder
DSM5 general criteria for alcohol use disorder AUD
maladaptive pattern of substance use leading to clinically significant impairment or distress occurring in a 12 month period
what are the criteria for AUD
alcohol taken in larger amounts persistent desire lot of time spent on alcohol craving/strong desire use results in failure to fulfill work... persistence despite problems caused by it hobbies/events stopped as a result use in hazardous situations persistence despite evidence of harm tolerance withdrawal
how many criteria do you need
2 or more
what are the subtypes of alcohol use disorder
mild
moderate
severe
define mild AUD
2-3 symptoms
define moderate AUD
4-5 symptoms
define severe AUD
6 or more symptoms
what does AUDIT stand for
Alcohol Use Disorder Identification Test
what is AUDIT
comprehensive 10Q alcohol harm screening tool made by WHO
AUDIT score of __ indicates possible dependence, what is the next step
20 or more
use another tool (SADQ)
what does SADQ stand for
Severity of Alcohol Dependence Questionnaire
what elements does SADQ measure
physical withdrawal affective withdrawal withdrawal relief drinking alcohol consumption rapidity od reinstatement
what is CIWA-AR
used in assessment and management of alcohol withdrawal
AUDIT score for low risk drinking
6-7
AUDIT score for hazardous drinking
8-14
AUDIT score for harmful drinking
15-18
AUDIT score for possible dependence
> =20
what should be done in those with harmful drinking
deliver brief intervention
deliver motivational enhancement therapy
consider prescribing options
what should be done for those with hazardous drinking
deliver brief intervention
what is used in brief intervention
FRAMES model Feedback Responsibility Advice Menu Empathy Self efficacy
what is motivational enhancement therapy MET and what is used
Readiness for change questionnaire
features of alcohol withdrawal syndrome
tremor sweating nausea + retching tachycardia, hypertension, fever anxiety and agitation insomnia, nightmares hallucinations withdrawal seizures delirium tremens
onset of withdrawal seizures
0-48 hours
onset of delirium tremens
48-72 hours
features of complicated withdrawal
seizures
hallucinations
delirium tremens
Wernicke-Korsakoff
which medication is used for alcohol withdrawal
chlordiazepoxide (BZD)
for symptomatic relief acutely
how long should chlordiazepoxide be used
1 week
definitely not more than 1 month
what is the kindling effect
severity of withdrawal symptoms tends to increase after each alcohol withdrawal
what methods of relapse prevention are there
psychosocial intervention
pharmacological intervention
what does psychosocial intervention involve
CBT
MET
12 step facilitation therapy
family + couple therapy
what can be used in pharmacological therapy long term
acamprosate
naltrexone
disulfiram
nalmefene
acamprosate mechanism
corrects GABA/glutamate imbalance
reduces cravings
acamprosate only works when patient is abstinent, true or false
true
mechanism of naltrexone
opioid receptor antagonist
blocks endorphin effect
mechanism of disulfiram
creates unpleasant side effects when taken with alcohol
has a low compliance rate
mechanism of nalmefene
opioid receptor antagonist
taken a few hours before social drinking
can you determine the severity of alcohol dependence from number of units consumed per week
no
