Substance Use Disorder (19)

Question 1

what does alcohol do to the brain?

Answer 1

depresses frontal lobe activity

(manifests as euphoria, disinhibition, impaired judgment)

Question 2

what happens when blood levels rise with alcohol?

Answer 2

parietal lobe activity is depressed

(manifests as impaired speech and motor function)

Question 3

other effects of alcohol on the brain

Answer 3

depressed occipital lobe (impaired vision)

impaired cerebellum (affected balance) and brain stem (coma and respiratory depression)

Question 4

withdrawal symptoms

Answer 4

course hand tremors, nausea, vomiting, headache, malaise

HTN, hyperthermia, diaphoresis, (autonomic activation)

occasional seizures

Question 5

what is Delirium Tremens?

Answer 5

severe withdrawal manifesting as extreme confusion, visual hallucinations, autonomic activation

immediate proper treatment is critical to avoid death

Question 6

what is Wernicke-Korsakoff Syndrome?

Answer 6

Wernicke’s Encephalopathy - abnormal eye movements, ataxia, stupor, confusion

Korsakoff’s psychosis - the inability to convert short-term memories to long-term (confabulation)

Question 7

what causes W-K syndrome?

Answer 7

thiamine deficiency (from poor intake or poor absorption by heavy drinking)

Question 8

screening tools for at-risk drinkers

Answer 8

AUDIT-C and CAGE questionnaire

Question 9

psychotherapy for alcohol use disorder

Answer 9

CBT, motivational interviewing, group therapy

Question 10

medications and fluids for withdrawal

Answer 10

benzodiazepines, banana bag (IV bag w/ thiamine, folate, dextrose, multivits)

Question 11

counseling for patients w/ alcohol use disorder

Answer 11

therapeutic relationship is a partnership, goal of exploring and resolving ambivalence (enjoying yet disliking addiction), avoid direct persuasion

assume a quiet and eliciting demeanor

remember it is a slow and passive process, but they will get there