Alcohol Use Disorders Flashcards
What are the genetic factors in AUD?
- 40-60% genetic influence
- heterogeneous contribution
- gene studies: chromosome 4 offers protection, chromosome 1 and 7 contributes to vulnerability.
What are the four environmental factors that contribute to AUD?
- political and economic factors
- socio-cultural factors eg rites of passage
- occupation eg hospitality industry, FIFO workers; time away from home increases ETOH
- family experience of heavy drinking eg raised in a pub
What is the relationship between stress and alcohol?
- increased frequency of stressful life events precedes alcohol use
- alcohol relieves anxiety by acting on dopamine. Anxiety precedes alcohol, depression follows
- if person is stress-reactive then more sensitive to stress and alcohol
How do you calculate the content of alcohol?
mL x %strength x .79gm of ethanol / 10
1mL ethanol = .79gm of pure ethanol
10 gms alcohol = 1 std drink
What are the 3 milestones/phases of drinking?
- Evolution of drinking
- Evolution of drinking problems
- Evolution of dependence
What are the 6 effective CBT treatments?
No single category but several methods: - Behavioural self-control - Behavioural contracting - Social skills training - Cue exposure - Behavioural marital therapy - Relapse prevention MI
Describe characteristics of 5 intervention goals and give examples.
- Negotiated
- Specific, observable
- ST targets
- Achievable
- Priorities
E.g. Change how fast alcohol taken, drink water/coke every second drink, reduce frequency, dose or mix of alcohol (light beers), reducing alcohol related behaviours, abstinence
What are the components of self-management plans?
- remove self from triggers
- manage environment
- use different behaviour in same envt
- set limits to use
- strategies to keep limits
- manage cognition about drinking
- manage emotions
- drink refusal skills
- dealing with urges
What are 6 strategies for setting limits?
- realistic and concrete eg 2 per day
- if bingeing, set maximum daily limit
- if binge then have next two days alcohol free
- 2 alcohol free days per week
- taper each week to 0
- follow national guidelines
What are some strategies for keeping to limits?
- Plan ahead
- count drinks
- slow down (no gulping, put glass down, don’t refill)
- alternate with non-alcoholic, dilute drinks
- drink lower alcohol content, smaller drinks
- don’t drink to quench thirst
- eat before drinking, no salty nibbles
- don’t ‘shout’ or have favourite drink
- drink refusal skills
What are the most widely used empirically-supported approaches in AUD treatment?
- Brief intervention
- MI
- CBT
Stepped care is recommended
What are the steps in functional analysis?
- Triggers: env’t, interpersonal, emotions, thoughts, physical sensations
- Thoughts/feelings/images: eg I need a drink
- Drink: Did one lead to another? Was this intentional
- Positive consequences (usually immediate)
- Negative consequences (later)
What do you teach clients about cognitions and drinking?
- the connection between situations, thoughts, feelings, behaviour, drinking
- use thought monitoring to clarify
- focus on: cognitive distortions (coping with stress) and temptation coping
What are four targets for addressing problematic alcohol-related cognitions?
- Cognitive distortions and schemas (perfectionism, things have to go the way I want them to)
- Thoughts/images about alcohol/things associated with alcohol create urges
- Thoughts about positive effects ‘One won’t hurt’
- Negative thinking eg self-talk
Teach them stop, think, re-think
How can you teach clients to cope with thoughts/images about drinking?
Stop, think, rethink
Review pros and cons:
- positive and negative consequences
- recall core values of why you want to stop
- refocus on positive consequences of not drinking
