Alcoholism - Dr. Allen Flashcards
What are the three components of substance use, with respect to population health?
Substance, Set, and Setting
About what percentage of people you’ll see will have problems with alcohol?
About 10%
What is tolerance?
A reduced sensitivity requiring higher quantities of alcohol be consumed in order to achieve the same effects
What is withdrawal and what are its symptoms?
A set of symptoms that can occur when an individual reduces or stops alcoholic consumption after long periods of use
Alcohol withdrawal syndrome–at least two of the following symptoms:
increased hand tremor insomnia nausea or vomiting transient hallucinations (auditory, visual or tactile) psychomotor agitation anxiety tonic-clonic seizures autonomic instability
What is a craving and what are its factors?
Desire or urge to consume alcohol.
Physical
Psychological
What are some DSM-5 qualifiers for alcoholism?
“A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12 month period.”
-Alcohol is often taken in larger amounts or over a longer period of time than 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 where it is physically dangerous.
-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.
And tolerance or withdrawal.
How is severity determined for alcoholism?
Mild: 2-3 symptoms.
Moderate: 4-5 symptoms.
Severe: 6 or more symptoms.
DSM-IV only required one criteria.
What were three major changes in the formation of DSM-5 for alcoholism?
Removal of:
Legal problems as diagnostic criteria.
The distinction between “abuse” and “dependence.”
Addition of:
Craving as criteria.
How did DSM IV define substance abuse and substance dependence?
DSM-IV substance abuse required a threshold of one or more criteria
DSM-IV substance dependence required a threshold of three or more criteria
What do alcoholism and gambling disorders have in common?
They activate the same reward system.
Highest and lowest incidence of drinking WRT ethnic group?
Whites - highest
Asian - lowest
(T/F) American Indian people have highest rates of binge and heavy use
True. But the majority of AI people didn’t haven’t drank in the past month.
(T/F) Higher education is associated with lower alcohol use.
False.
(T/F) Women drink more than men.
False.
What are some non-ethnic group at risk populations?
Western Midwest
College students.
What does CAGE stand for?
Have you felt you should CUT down?
Have people Annoyed you by criticizing your drinking?
Have you ever felt Guilty about your drinking?
Have you ever drank to steady your nerves or to get rid of a hangover? (Eye opener)
What are some details of AA?
Self-help approach
Attendance in meetings lead by non-professional lay leaders also in recovery from alcohol
New enrollees are paired with a sponsor, a more senior person in longer term recovery
12 step program
12 steps in the development of a recovery from alcoholism
Spiritual basis - involves placing control over life and cravings in a higher power
Abstinence based
Motivational interviewing is [ ] centered and [ ] oriented. It aims to enhance [ ] by resolving [ ]
Person; Goal; Motivation; Ambivalence.
What percentage of people with substance use disorders are in precontemplation or contemplation stages?
80%
Our role as physicians isn’t necessarily abstinence, but helping to define success from moving one stage to the next.
Stages of Change Transtheoretical Model (5)
Precontemplation Contemplation Determination/Preparation Action Maintenance
Harm Reduction Methods?
Safer route of drug administration Alternative, safer substances Reduce frequency of drug use Reduce intensity of drug use Reduce harmful consequences of drug use
What is the BASICS model for college students?
Keep Track Slow Down Space Your Drinks Select Different Types of Drinks Drink for Quality instead of Quantity Enjoy Mild Effects
