Chapter 6 - Substance Use Assessment

Question 1

Alcohol

Answer 1

- 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.

Question 2

Alcohol Consumption

Answer 2

Low-to-moderate
Men < 2 drinks/day
Women < 1 drink/day

Many patients in hospital and primary care setting with an AUD

Question 3

Alcohol Interactive (AI)

Answer 3

45% of prescription medications are classified as AI.

Question 4

Adverse Drug Reactions

Answer 4

Combination of alcohol and drugs can cause ADR

Question 5

Breast cancer

Answer 5

Drinking more than 30 grams/day increases rate of breast cancer.

Question 6

Heavy drinking

Answer 6

> 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.

Question 7

Alcoholism

Answer 7

A major cause of liver cirrhosis

Question 8

Drinking and pregnancy

Answer 8

No safe limit of drinking for pregnant women.

Can cause fetal alcohol syndrome and preterm problems

Question 9

Binge drinking

Answer 9

> 5 drinks/occasion - men
4 drinks/occasion - women

Increases risk for injuries, violence, alcohol poisoning, risky sexual behaviors, sexually transmitted disease, and unintended pregnancy.

Question 10

Effects of alcohol

Answer 10

Hypertension, arterial plaque buildup, baroreceptor reflex changes, body fluid changes, activation of the sympathetic nervous system

Question 11

Illicit drug use (7 categories)

Answer 11

Marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, and the nonmedical use of psychotherapeutics (prescription pain relievers, tranquilizers, stimulants, and sedatives)

Question 12

Marijuana

Answer 12

The most common (used by almost 80%)

Question 13

Opioid epidemics

Answer 13

prescription drug abuse
Contributing Factors
- increases in prescriptions for pain
- combination of drinking alcohol and taking alcohol-interactive (AI) drugs

Question 14

AUDIT questionnaire

Answer 14

• assess alcohol consumption, drinking behavior or dependence, and adverse consequences of alcohol.

Question 15

CAGE questionnaire

Answer 15

• uses the mnemonic to ask four questions testing for lifetime alcohol abuse/dependence
• less effective with women and minority groups

Question 16

TWEAK questionnaire

Answer 16

• for women

- assesses tolerance, worry, eye-opener, amenesia, and kut down

Question 17

SMAST-G tool

Answer 17

• for older adults who report social and regular drinking

- the tool can reveal an alcohol problem and a need for more in-depth assessment

Question 18

GGT (gamma-glutamyl transferase)

Answer 18

• increase levels suggest chronic heavy alcohol use

Question 19

CBT (Carbohydrate-deficient transferrin

Answer 19

• a test used with GGT test to improve accuracy in detecting alcohol abuse

Question 20

AST (aspartate aminotransferase)

Answer 20

• increased serum levels indicate months of chronic drinking

Question 21

MCV (Mean corpuscular volume)

Answer 21

• a biomarker for problem drinking

- it is not sensitive enough to be used alone to detect drinking problem

Question 22

PEth (phosphatidyl ethanol)

Answer 22

• a biomarker that helps to evaluate abstinence and sober living

Question 23

Breath alcohol analysis

Answer 23

• detects alcohol, in the end exhaled air

- conducted on an intoxicated individual

Question 24

Blood alcohol concentration (BAC)

Answer 24

• values to determine alcohol in blood

- conducted on an intoxicated individual

Question 25

Clinical Institute Withdrawal Assessment (CIWA)

Answer 25

• 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