Lecture 9 Alcohol use

Question 1

What percentage of Canadian adults consumer alcoholic beverages at least occasionally?

Answer 1

75% and 51% of that is beer

Question 2

Alcohol use disorder

Answer 2

• AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using
• (meet any two of the 11 DSM criteria)

Question 3

Alcohol use disorder demographic

Answer 3

• More common in males than females
• More common in younger people
• Affects any socio-economic background

Question 4

What is AUD most comorbid with?

Answer 4

Depression, (Males: 60%, Females: 33%)

Question 5

Treatment concerns regarding AUD?

Answer 5

• No gold standard
• Anyone can run a treatment center without credentials or scientific research to back it up
• Some options are too pricey- not covered by insurance
• Few programs report success rates

Question 6

Key treatment targets for all treatments

Answer 6

• Increase motivation to change
• Increase capabilities or skills (skills training)
• Change cognitions that promote use
• Change reinforcers related to substance use
• Prevent relapse

Question 7

Is there a difference in effectiveness between Motivational Interviewing, Cognitive Behavioural Coping skills, and 12 Step Facilitation therapy?

Answer 7

Few significant differences, most patients did not maintain complete abstinence but all led to reductions in outcome variables.

-One matching characteristic: low-psychiatric severity patients has more abstinent days with 12-step

Question 8

Motivational Interviewing

Answer 8

• An intervention that promotes motivation to change

- Therapist acts as a person of support, allowing client to make their own choices and arrive at their own conclusions

Question 9

Key elements of Motivational interviewing

Answer 9

• Collaboration
• Compassion
• Evocation (of internal desire for change)
• Acceptance and trust in the autonomy of the client

Question 10

FRAMES of Motivational Interviewing

Answer 10

F: Feedback 
R: personal Responsibility of client for change
A: clear Advice
M: Menu of options for client
E: Empathetic treatment
S: Self-Efficacy is increased/changed

Question 11

Stages of Change (M.I)

Answer 11

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance/Relapse

Question 12

Early sobriety strategies (CBT)

Answer 12

1. Stimulus control
2. Dealing with urges
3. Addressing Cognitive distortions about alcohol
4. Alternative/Distracting behaviours
5. Identifying Alternative ways to obtain reinforce
6. Drink refusal skills

Question 13

12 step programs

Answer 13

• 90 day induction period
• sponsors as mentors
• 12 steps

Question 14

Pharmacological Models

Answer 14

• Admit to residential/semi-residential treatment
• Little emphases on psychological or social interventions
• Drug replacement to ameliorate withdrawal

Question 15

Chance of Relapse for AUD

Answer 15

2/3 or 66%

Question 16

Lapse vs Relapse

Answer 16

A Laspe is a temporary blip (drinking on your bday)

A Relapse is a return to previous state (drinking every other day)

Question 17

Two processes of relapse

Answer 17

1) Abstinence Violation Effect:: ‘ahh what the hell’ effect

2) Apparently Irrelevant behaviours

Question 18

2 steps after a Lapse

Answer 18

1) Identify Stimuli that trigger cravings

2) Problem solve on how modify/avoid/resist