Drugs and Alcohol

Question 1

What is a good screening question for alcohol?

Answer 1

How many times in the past year have you had 5 or more drinks in a day (for men) or 4 or more drinks in a day (women)? Any number greater than 0 is a positive screen

Question 2

What are standard questions for alcohol addiction?

Answer 2

CAGE
Have you ever tried to cut down on your drinking?
Have you ever been annoyed by others criticizing your drinking?
Have you ever felt guilty about your drinking?
Do you find that you ever need an “eye-opener”

Question 3

What are the 5 As of behavior change

Answer 3

assess
advise
agree
assist
arrange

Question 4

What are success rates for the first year of treatment?

Answer 4

30-50% of users are abstinent after the first year

Question 5

disulfram

Answer 5

blocks alcohol dehydrogenase, leading to build up of acetaldehyde: flushing, tachycardia, nausea if they drink. Requires routine liver function tests

Question 6

Naltrexone

Answer 6

opioid antagonist that affects endogenous opiods released by alcohol consution. Decreases alcohol craving and use. SE is nausea and may cause opiate withdrawal in opiate addicted alcoholics
ReVia

Question 7

What is acamprosate?

Answer 7

blocks glutamingergic NMDA receptors and activates GABA type A receptors to decreases alcohol craving and use. Can be used in opiate-addicted alcoholics

Question 8

What is Vivitrol?

Answer 8

naltrexone monthly injection- IM form. Avoids first pass effect but is expensive and needs more paperwork

Question 9

What is methodone?

Answer 9

full agonist at the mu receptor
causes little euphoria
visit clinic daily

Question 10

What is buprenorphine/naloxone?

Answer 10

suboxone

partial agonist against mu receptor. Can be prescribed by PCPs

Question 11

What is varenicline/Chantix?

Answer 11

drug for smoking cessation

partial agonist at the nicotinic receptor