Addictive Behaviour SDL

Question 1

Define hazardous drinking

Answer 1

a level of drinking that increases the risk of harmful consequences for the user

• drink over the receommnede limbs,
• have so far avoided significant alcohol-related problems

Question 2

Define harmful drinking

Answer 2

drinking at a level leading to physical, social or psychological harm

Question 3

Define alcohol dependence

Answer 3

3 or more of a range of symptoms including: tolerance, withdrawal, craving, relief of withdrawal, neglect of alternative pleasures, persistence despite consequences

Question 4

How is the amount of alcohol in a drink calculated?

Answer 4

volume X ABV / 1000

Question 5

What are the recommend alcohol limits in the UK?

Answer 5

• no safe amount

- no more than 14 units a week

Question 6

Define binge drinking

Answer 6

excessive consumption of alcohol over a short period of time

Question 7

What factors can cause alcoholism?

Answer 7

• > 12/15 drinks a week
• more than 5 drinks a day
• parent with alcoholism
• coexisting mental health problems
• young adult, peer pressure
• low self esteem
• high stress levels
• alcohol accepted culture
• close relative with alcoholism

Question 8

Patient comes in early in the morning smelling of alcohol. What should you do? What treatment options are available?

Answer 8

• talk to him about it
• suggest to book another appointment
• refer to nurse
• questionnaires e.g. AUDIT
• make patient make first AA appointmnet
• do blood tests, gammaGT, ATT, ALT, CRP

Question 9

Give 5 medical harms associated with hazardous and harmful use of alcohol

Answer 9

• injuries
• GI conditions
• cancer
• CVS disease
• pre-natal harm

Question 10

Give 5 social harms associated with hazardous and harmful use of alcohol

Answer 10

• marital harm
• social nuisances
• child abuse
• crime/violence
• homocide

Question 11

How can you identify hazardous and harmful alcohol use?

Answer 11

• measuring alcohol use

- screening instrument

Question 12

What does AUDIT stand for?
What was it designed for?
What is the format of it?

Answer 12

• Alcohol Use Disorder Identification Test
• Designed to detect at-risk, harmful or heavy drinking
• 10 questions covering the three domains of hazardous alcohol use, alcohol dependence and harmful alcohol use. Scored from 0-4, total score calculation

Question 13

Users normally respond better to audit when:
-
-
-
-
-

Answer 13

• the person conducting the interview is friendly and not threatening
• the aim of the question is clearly related to diagnosing the users state of health
• the user does not consume alcohol or drugs whilst the selection is made
• the information is considered to be confidential
• the questions are easy to understand

Question 14

What AUDIT score suggest a potential problem?
What items suggest harmful alcohol consumption?
What items suggest the beginnings of dependency?

Answer 14

8 or above
7-10
4-6

Question 15

What are the shortened versions of AUDIT?

Answer 15

• AUDIT
  FAST (fast alcohol screening test)
• 5 shot questionnaire

Question 16

Why are biochemical tests for alcohol use disorders such as liver enzymes and MCV not useful for screening?

Answer 16

poor sensitivity, only identify a small proportion of patents with hazardous or harmful alcohol consumption

Question 17

People drink in order to obtain certain advantages and it becomes a problem when:

Answer 17

• alcohol does not obtain the advantages that the person sought initially e.g. confidence, relaxation,
• longer term adverse consequences

Question 18

What might be the barriers to implementing the brief intervention approach?

Answer 18

• may require too much time
• inadequate training related to screening and counselling
• antagonising patients over a sensitive issue –> anger
• assumption that alcoholics do not respond to primary care interventions

Question 19

List the steps involved in brief intervention

Answer 19

1. introduce and indemnity that they are high risk-
2. explain health risks, give leaflet
3. show panel 3 and risks
4. discuss the need to stop or cut down
5. discuss sensible limits
6. what is a standard drink?
7. conclude with encouragement
   - be empathetic, non-judgemental, authoritative, deflect denial, facilitate and follow up

Question 20

What are the questions in the CAGE questionnaire?

Answer 20

• have you ever felt you should Cut down?
• have you every felt Annoyed when people criticise your drinking?
• have you have felt Guilty about your drinking?
• have you ever had a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?