Substance Abuse Disorder Flashcards
What is the triad for substance abuse?
(1) Psychological dependence or craving
(2) Physiologic dependence
(3) Tolerance
What is the 3rd leading preventable cause of death in the United States?
Alcohol Use Disorder
“Risky” alcohol use refers to…..
consumption of alcohol that puts patient at risk for health consequences
Nation Institute of Alcohol Abuse and Alcoholism (NIAAA) has estimated consumption amounts of alcohol that increase health risks:
1) Men under age of 65
–a) More than ___standard drinks per week on average
–b) More than ___ drinks on any day
—-(1 Standard drink: 5 oz of wine, 12 oz beer
–b) More than 4 drinks on any day
2) Women and adults 65 years and older
–a) More than __ standard drinks per week on average
–b) More than __ drinks on any day
1) a) 14
1) b) 4
2) b) 7
2) a) 3
Alcohol Use Disorder is diagnosed as mild, moderate, or severe on the basis of the number of the following present. How many is required for mild?
1) Recurrent drinking resulting in failure to fulfill role obligations
2) Recurrent drinking in hazardous situations
3) Continued drinking despite alcohol-related social or interpersonal problems
4) Evidence of tolerance
5) Evidence of alcohol withdrawal or use of alcohol for relief or avoidance of
withdrawal
6) Drinking in larger amounts for longer periods than intended
7) Persistent desire or unsuccessful attempts to stop or reduce drinking
8) Great deal of time spent obtaining, using, or recovering from alcohol
9) Important activities given up or reduced because of drinking
10) Continued drinking despite knowledge of problems caused
11) Alcohol craving
2-3
Medical Complications of alcohol use
1) HTN
2) Cardiovascular disease
3) Liver disease
4) Pancreatitis
5) Gastritis
6) Esophagitis
7) Neuropathy
there is strong association between alcoholism and psychiatric disorders such as:
1) Depression
2) Anxiety
3) PTSD
4) Eating disorders
5) Other substance use disorders
6) Sleep disturbances
7) Suicidal ideation and attempt
What are the “CAGE questions”?
What are they used for?
a) Have you ever felt you should Cut down on your drinking?
b) Have people Annoyed you by criticizing your drinking?
c) Have you ever felt bad or Guilty about your drinking?
d) Have you ever taken a drink first thing in the morning (Eye opener) to steady your nerves or get rid of a hangover?
Alcohol use disorder
True/False
The “Cage” questionnaire is a valid screening tool intended to detect full spectrum of unhealthy alcohol use
False
How many affirmative “CAGE” questions are:
a) 77% sensitive, 79% specific for alcohol abuse and dependence
b) 53% sensitive, 70% specific for unhealthy alcohol use
2 Affirmative questions
One complication of Alcohol use disorder is _________.
This is due to deficiency of Thiamine (Vitamin B1)
Wernicke Korsakoff syndrome
What issue?
acute syndrome
(1 Direct damage to the brain caused by thiamine deficiency
-a Demyelination, atrophy, hemorrhages, vascular congestion
(2 Triad
–(a Encephalopathy
–(b Disorientation, inattentiveness
–(c Oculomotor dysfunction
–(d Nystagmus most common finding
(3 Gait ataxia
(4 Wide based gait
(5 Slow, short spaced steps
(6 Most will not have triad
(7 Most common symptom: ConfusionW
Wernicke encephalopathy (WE)
What issue?
Chronic neuro condition
(1 Usually a consequence of WE
(2 It is a late neurophsychiatric manifestation of Wernickes
(3 Causes anterograde and retrograde amnesia
-(a Long term memory and cognitive skill impairment is less common
Korsakoff syndrome
True/False
Alcohol withdrawal is a potentially life-threatening problem
True
What issue?
Leading preventable cause of mortality worldwide
(a) Estimated cause of 6 million deaths worldwide
(b) 400,000 deaths in US annually
Tobacco use disorder