Chapter 6 - Substance Use Assessment Flashcards
Alcohol
- The most used and abused psychoactive drug Highest AUD (alcohol use disorder) in women, older adults, racial/ethnic minorities, and those with lower family income and educational level.
Alcohol Consumption
Low-to-moderate
Men < 2 drinks/day
Women < 1 drink/day
Many patients in hospital and primary care setting with an AUD
Alcohol Interactive (AI)
45% of prescription medications are classified as AI.
Adverse Drug Reactions
Combination of alcohol and drugs can cause ADR
Breast cancer
Drinking more than 30 grams/day increases rate of breast cancer.
Heavy drinking
> 15 drinks/week - Men
8 drinks/week - Women
Increases risks from chronic diseases (hypertension, heart disease, stroke, mental illness, learning and memory dysfunction. social issues, alcohol dependence or alcoholism.
Alcoholism
A major cause of liver cirrhosis
Drinking and pregnancy
No safe limit of drinking for pregnant women.
Can cause fetal alcohol syndrome and preterm problems
Binge drinking
> 5 drinks/occasion - men
4 drinks/occasion - women
Increases risk for injuries, violence, alcohol poisoning, risky sexual behaviors, sexually transmitted disease, and unintended pregnancy.
Effects of alcohol
Hypertension, arterial plaque buildup, baroreceptor reflex changes, body fluid changes, activation of the sympathetic nervous system
Illicit drug use (7 categories)
Marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, and the nonmedical use of psychotherapeutics (prescription pain relievers, tranquilizers, stimulants, and sedatives)
Marijuana
The most common (used by almost 80%)
Opioid epidemics
prescription drug abuse
Contributing Factors
- increases in prescriptions for pain
- combination of drinking alcohol and taking alcohol-interactive (AI) drugs
AUDIT questionnaire
- assess alcohol consumption, drinking behavior or dependence, and adverse consequences of alcohol.
CAGE questionnaire
- uses the mnemonic to ask four questions testing for lifetime alcohol abuse/dependence
- less effective with women and minority groups
TWEAK questionnaire
- for women
- assesses tolerance, worry, eye-opener, amenesia, and kut down
SMAST-G tool
- for older adults who report social and regular drinking
- the tool can reveal an alcohol problem and a need for more in-depth assessment
GGT (gamma-glutamyl transferase)
- increase levels suggest chronic heavy alcohol use
CBT (Carbohydrate-deficient transferrin
- a test used with GGT test to improve accuracy in detecting alcohol abuse
AST (aspartate aminotransferase)
- increased serum levels indicate months of chronic drinking
MCV (Mean corpuscular volume)
- a biomarker for problem drinking
- it is not sensitive enough to be used alone to detect drinking problem
PEth (phosphatidyl ethanol)
- a biomarker that helps to evaluate abstinence and sober living
Breath alcohol analysis
- detects alcohol, in the end exhaled air
- conducted on an intoxicated individual
Blood alcohol concentration (BAC)
- values to determine alcohol in blood
- conducted on an intoxicated individual
Clinical Institute Withdrawal Assessment (CIWA)
- used to measure withdrawal
- withdrawal symptoms - cravings for alcohol, irritability, anorexia, abdominal pain, fatigue
- withdrawal signs - chills, muscle cramps, palpitations, tachycardia, hypertension, fever, disorientation, slurred speech, staggering gait, and poor dexterity
