alcohol use & motivational interviewing

Question 1

what country are the highest consumers of alcohol in Europe?

Answer 1

ireland

Question 2

how many units of alcohol are safe per week for men vs women?

Answer 2

-men - 17 units
-women - 11 units

Question 3

according to the WHO, what can binge drinking be defined as?

Answer 3

6 units or more

Question 4

Describe the prevalence of binge drinking (internationally)

Answer 4

-depends strongly on number of abstainers in a country eg US, Europe vs eastern mediterranean (much less)
-more common in men
-increases sharply in adolescents and peaks in early adulthood (20-25), before declining but not for all countries

Question 5

what are examples of symptoms of alcohol use disorders?

Answer 5

-tolerance - ie it takes more drink to feel the buzz
-recurrent use resulting in hazardous situations
-alcohol craving
-drinking in larger amounts or for longer than intended
-great deal of time spent obtaining, using, or recovering from alcohol
-important activities given up/reduced due to drinking

Question 6

what is alcohol consumption associated with (dangers)?

Answer 6

• global deaths
  -suicides
  -murders
  -deaths from fire
  -RTA’s
  -drownings
  -child abuse

Question 7

what are the risks of alcohol abuse and use on single occasions (ie binge drinking)?

Answer 7

-accidents, falls, drownings, disability, alcohol poisoning, death
-hangovers, blackouts, memory loss
-academic/educational impairment, missed classes etc
-unwanted pregnancies, HIV and other STI’s

Question 8

what are the risks of alcohol use and abuse for regular heavy drinking?

Answer 8

-liver cirrhosis
-acute pancreatitis
-irreversible neurological damage
-increased risk of CVS disease
-alcohol dependence

Question 9

why do we drink alcohol?

Answer 9

-personality - if you are introverted, if you are impulsive etc
-self medication/ coping - stress, trauma, depression etc
-parents - increase in drinking if parents are authoritarian / neglectful (v strict)
-peers - higher social status for bingeing
-environment, culture etc

Question 10

what is the CAGE questionnaire?

Answer 10

• have you ever felt that you should Cut down on your drinking?
  -have people Annoyed you by criticising your drinking?
  -have you ever felt bad or Guilty about your drinking?
  have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)
  -score as 1/0 or yes/no

Question 11

what score on the CAGE questionnaire indicates dependence problems?

Answer 11

2 or more

Question 12

what is the AUDIT C test?

Answer 12

-alcohol users disorders identification test
-3 questions - with a score system from 0-4

Question 13

what are the 5 As?

Answer 13

-ask
-advice
-assess
-assist
-arrange follow up

Question 14

Describe the 5As

Answer 14

• ask - ask all patients
  -advice - brief advice on health effects (non judgemental)
  -assess- readiness to quit (wheel/stages of change)
  -assist - strategies for reduction - explore barriers etc
  -arrange follow up - for further support

Question 15

what is the OARS technique?

Answer 15

-Open ended questions
-affirmations
-reflective listening
-summarising

Question 16

how can the OARS technique be applied to someone who is abusing alcohol?

Answer 16

-the HCP could ask open ended questions such as ‘ can you tell me more about your current alcohol consumption’?
-the HCP can provide support by using affirmations eg I appreciate your honesty in discussing your alcohol use
-HCP could engage reflecting listening which demonstrates empathy and understanding towards the patient
-The HCP can summarise the key points of the conversation

Question 17

describe the 5as approach in detail

Answer 17

1. ASK - ask all patients at every visit - record all info for behavioural risk factors
2. advise - provide basic advice on the negative health effects in a non-judgemental way
3. assess - determine the willingness and confidence of the patient to make a quit attempt- using MI skills, TTM model to identify state of change
4. ASSIST - develop plan , goal setting and provide support
5. arrange - follow up appointment within 1 month, provide further support

Question 18

what are examples of motivational interviewing tools?

Answer 18

-OARS - open ended questions, affirmations, reflective listening & summarising
-80:20 rule
-0-10 scaling exercise

Question 19

describe the 80:20 rule

Answer 19

the patient should do 80% of the talking and the HCP the other 20%

Question 20

describe the 0-10 scaling exercise & give 2 examples

Answer 20

-scaling question
eg on a scale of 0-10 how important is it for you to quit smoking etc?
- eg 2) on a scale of 0-10 how confident are you that you could quit etc ?