WK 7-ALCOHOL, TOBACCO AND CANNABIS Flashcards
What are the drinking guidelines
- MEN and WOMEN no more than TWO standard drinks daily to decrease LIFETIME RISK of DEATH from DISEASE or INJURY due to alcohol (chronic harms)
- MEN and WOMEN no more than FOUR on any ONE OCCASION to decrease risk of INJURY or HARM from that occasion (acute harms)
- Under 18 NO ALCOHOL because of increased risk of dependence associated with age on onset
- NO ALCOHOL during pregnancy or breastfeeding
Why is smoking and consuming alcohol at the same time more detrimental for health (why is there an increase in head/neck cancer)
Alcohol can cross membranes (without breaking the membrane)→ can take molecules with it (like tobacco) → move tobacco molecules into the fat of the head/neck
What are some of the psychological effects of alcohol
- Insomnia
- Fatigue
- Anxiety/depression
- Suicidal ideation
- Exacerbation of mental health issues
What is the difference between intoxication and overdose?
Intoxication= immediate, short term effects
Overdose (poisoning)= long term effects including withdrawal and tolerance
What is foetal alcohol syndrome- what are some of the characteristics
When the foetal brain is exposed to alcohol during development it can cause structural malformations (disrupts connections between hemispheres)
Features; flat midface, short nose, thin upper lip, short palpebral fissures, indistinct philtrum, epicanthal folds, low nasal bridge, minor ear anomalies
What are 2 types of screening mechanisms used to screen for alcohol dependence
C.A.G.E and AUDIT (Audit C is the shorter version)
What are the 4 questions asked in a C.A.G.E screening
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticising your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?
What are the 3 questions asked in AUDIT-C- what score is a ‘positive’ result in women/men
1: How often did you have a drink containing alcohol in the past year?
Q2: How many drinks did you have on a typical day when you were drinking in the past year?
Q3:How often did you have six or more drinks on one occasion in the past year?
Men= 4+
Women= 3+
What are the national guidelines for treatment of alcohol problems
- Level A recommendations: ASK
- Screening with AUDIT for the general population should be widely implemented in GP and ED
- Screening with indirect biological markers (LFT-liver function test) should only be used as an adjunct to AUDIT – less sensitive and specific
Where should ‘brief interventions’ for alcohol use be used? What kind of people should they not be used on?
Brief interventions are useful in GP/ED settings and are effective in reducing alcohol use in people with risky drinking patterns but are not dependent–> they should not be used for people who are alcohol dependent
What acronym is used for ‘brief interventions’ of alcohol use
FLAGS F= feedback L= listening A= advice G= goals S= strategies
What are 3 examples of psychosocial interventions used in alcohol use
Motivational interviewing (first line or stand alone treatment), Behavioural self management (if low or no dependence) and Coping skills
What are the 3 drugs used to treat dependent drinkers
- Acamprosate
- Naltrexone
- Disulfiram
What is the MOA of acamprosate in the treatment of alcoholism- what is the precaution
Acamprosate blocks glutamate receptors and activates GABA receptors–> provides fewer side effects of alcohol
-need to have normal renal function
What is the MOA of naltrexone in the treatment of alcoholism- what is the precaution
Blocks opioid receptors-> taken once daily
-need normal liver function
What is the MOA of disulfiram in the treatment of alcoholism
Aversive agent-> blocks alcohol dehydrogenase increasing the ‘unwell’ feeling you get when drinking alcohol-> closely supervise