Public health Flashcards
Acute effects of excess alcohol
Accidents and injury
Coma and death from respiratory depression
Aspiration pneumonia
Oesophagitis/ gastritis
Mallory-Weiss syndrome (gastric tears)
Pancreatitis
Cardiac arrhythmias
Cerebrovascular accidents
Neurapraxia due to compression
Myopathy/rhabdomyolysis
Hypoglycaemia
Chronic effects of excess alcohol
Pancriatitis
CNS toxicity:
dementia
Wernicke-Korsakoff syndrome
cerebellar degeneration
Marchiafava-Bignami syndrome
central pontine myelinolysis
Liver damage:
fatty change
hepatitis
Cirrhosis
Hepatic carcinoma
Cancers:
Breast
Bowel
Mouth
Throat (oesophagus, larynx, pharynx)
Liver
Hypertension
Peripheral neuropathy
Oesophagitis
Cardiomyopathy
Gastritis
Cerebrovascular accidents
Osteoporosis
Malabsorption
Coronary heart disease
Skin disorders
Alcohol withdrawal
Foetal Alcohol Spectrum Disorder (FASD)
Psychosocial effects of excessive alcohol consumption
Interpersonal Relationships
Violence
Rape
Depression or anxiety
Problems at Work
Criminality
Social Disintegration
Poverty
Driving incidents/offences
Alcohol trends over time
Decreasing levels of harmful levels of alcohol consumption
Hospital admissions still increasing
Increased alcohol deaths in past few years
Less medical intervention required to stop drinking harmfully
Highest rates in 50s/60s y/o
Youth consumtion decreasing
More deprived - less likely to drink harmfully, BUT experiencing highest alcohol related death rates
NICE recommendation for policy to reduce alcohol disorders
- Price - Make alcohol less affordable
- Availability - licensing & import allowances
- Marketing - limit exposure, esp.to children and young people
NICE recommendation for Practice to reduce alcohol disorders
4: Licensing
5, 7-11: Screening & brief interventions
6: Supporting children & young people aged 10-15 yrs (personal or alcohol at home/in environment)
12: Referral - consider referral for specialist treatment
Measure to prevent alcohol harm
Restrict choice:
- Minimum unit pricing
- Restriction on ads (not allowed: appeal to young people, sexual content & irresponsible or antisocial behaviour)
Enable choice e.g. via Dry January
Provide info (not much effect individually but helps set context for other policies)
- Alcohol labelling (industry self-regulation)
- Drinking guidelines
- Media campaigns
How does Minimum unit pricing work
Set baseline of 50p per unit to restrict how cheap alcohol can be
Affects heavy drinkers most (if they are drinking a lot tend to go for cheaper stuff - also affects lower income ppl who get more harm per drink)
- moderate drinkers tend to drink more expensive stuff anyways
Unfortunately dependant drinkers are not very rational so may sacrifice other things like heating/food to get drinks
- This is only like 4% of ppl tho so most ppl will likely reduce drinking/respond to MUP
Already used in Scot and Wales. North Irland planning to use it. Evidence shows there is DECREASED ALCOHOL PUCHASING
However evidence shows there is:
- Little impact on crime
- No impact on hospital admissions
Health improvements after 1 month abstinence among weekly drinkers
IMPROVED:
- Insulin resistance
- Blood pressure
- Cancer-related growth factors
Outcomes of temporary abstinance initiatives
Reduced drinking at 6 months follow-up
Increased ability to refuse drinks
Improved self-rated health and wellbeing
lab tests results that can suggest problem drinking
Abnormal liver enzymes
Macrocytosis
High carb-deficient transferrin
Clinical indications for alcohol screening
As part of routine examination
Before prescribing medication
In the emergency department
In patients who are…
- Pregnant or trying to conceive
- Likely to drink heavily (e.g. smokers, middle-aged adults)
- Having health problems that might be alcohol induced
- Experiencing chronic illness not responding to treatment
Primary prevention of stroke
- Smoking/alcohol cessation
- Improved diet + physical activity
