Alcoholism - Dr. Allen

Question 1

What are the three components of substance use, with respect to population health?

Answer 1

Substance, Set, and Setting

Question 2

About what percentage of people you’ll see will have problems with alcohol?

Answer 2

About 10%

Question 3

What is tolerance?

Answer 3

A reduced sensitivity requiring higher quantities of alcohol be consumed in order to achieve the same effects

Question 4

What is withdrawal and what are its symptoms?

Answer 4

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

Question 5

What is a craving and what are its factors?

Answer 5

Desire or urge to consume alcohol.
Physical
Psychological

Question 6

What are some DSM-5 qualifiers for alcoholism?

Answer 6

“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.

Question 7

How is severity determined for alcoholism?

Answer 7

Mild: 2-3 symptoms.
Moderate: 4-5 symptoms.
Severe: 6 or more symptoms.

DSM-IV only required one criteria.

Question 8

What were three major changes in the formation of DSM-5 for alcoholism?

Answer 8

Removal of:
Legal problems as diagnostic criteria.
The distinction between “abuse” and “dependence.”

Addition of:
Craving as criteria.

Question 9

How did DSM IV define substance abuse and substance dependence?

Answer 9

DSM-IV substance abuse required a threshold of one or more criteria
DSM-IV substance dependence required a threshold of three or more criteria

Question 10

What do alcoholism and gambling disorders have in common?

Answer 10

They activate the same reward system.

Question 11

Highest and lowest incidence of drinking WRT ethnic group?

Answer 11

Whites - highest

Asian - lowest

Question 12

(T/F) American Indian people have highest rates of binge and heavy use

Answer 12

True. But the majority of AI people didn’t haven’t drank in the past month.

Question 13

(T/F) Higher education is associated with lower alcohol use.

Answer 13

False.

Question 14

(T/F) Women drink more than men.

Answer 14

False.

Question 15

What are some non-ethnic group at risk populations?

Answer 15

Western Midwest

College students.

Question 16

What does CAGE stand for?

Answer 16

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)

Question 17

What are some details of AA?

Answer 17

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

Question 18

Motivational interviewing is [ ] centered and [ ] oriented. It aims to enhance [ ] by resolving [ ]

Answer 18

Person; Goal; Motivation; Ambivalence.

Question 19

What percentage of people with substance use disorders are in precontemplation or contemplation stages?

Answer 19

80%

Our role as physicians isn’t necessarily abstinence, but helping to define success from moving one stage to the next.

Question 20

Stages of Change Transtheoretical Model (5)

Answer 20

Precontemplation
Contemplation
Determination/Preparation
Action
Maintenance

Question 21

Harm Reduction Methods?

Answer 21

Safer route of drug administration
Alternative, safer substances
Reduce frequency of drug use
Reduce intensity of drug use
Reduce harmful consequences of drug use

Question 22

What is the BASICS model for college students?

Answer 22

Keep Track
Slow Down 
Space Your Drinks
Select Different Types of Drinks
Drink for Quality instead of Quantity
Enjoy Mild Effects