Lecture 14 & 15: Alcohol brief intervention & nicotine smoking cessation

Question 1

What can alcohol misuse cause?

Answer 1

• Stroke
• Heart disease/irregular heart beat
• HTN
• Liver cirrhosis and cancer
• Reduced fertility
• Depression and anxiety
• Cancer of mouth, throat

Question 2

What is an AUDIT?

Answer 2

• Alcohol Use disorders identification test
• Comprehensive assessment by specialist alcohol services

Question 3

What is the recommended weekly basis drinking?

Answer 3

• No more than 14 units of alcohol per week
• Spread across 3 days

Question 4

What is the disorder called that alcohol can cause to foetus?

Answer 4

• Foetal alcohol spectrum disorder

Question 5

What is an ABI?

Answer 5

• Alcohol Brief Intervention
• Short structured conversation aimed at encouraging individuals to reduce their alcohol if they are drinking at hazardous or harmful lvls

Question 6

What are the key components of ABI?

Answer 6

• Screening
• Feedback/Responsibility
• Advice
• Goal setting/ Menu of options/Empathy/Self-efficacy
• Follow up

Question 7

What are the different screening tools in ABI?

Answer 7

• Use AUDIT (full 10 Q tool)
• Short form AUDIT C comprises the 1st 3 Qs
• Each Q is scored, cumulative score from all 3 Qs is diagnostic
• Scores indicate referral to GP or specialist

Question 8

What are communication techniques for ABIs?

Answer 8

• Use open-ended Qs
• Active listening
• Express empathy
• Avoid confrontation
• Encourage efficacy

Question 9

What are the benefits and challenges of ABIs?

Answer 9

• Reduces alcohol intake, Cost effective, Make every contact count
• Limited effectiveness in pharmacy settings
• More studies for pharmacy context

Question 10

What are the better ways to say:
- Drug user
- Rehab
- Addict
- Clean
- Replacement Therapy
- Relapse

Answer 10

• Person who uses drugs
• Treatment
• Person with a substance use disorder
• Substance free/ sober
• Medication assisted recovery
• Recurrence of ue

Question 11

How should mild, moderate and severe alcohol dependence be managed?

Answer 11

• Mild: dont need assisted alcohol withdrawal
• Moderate: Community pharm/GP
• Severe: specialist in secondary care and for those at risk of seizures and delirium tremens (dip in cognitive function)

Question 12

What are signs of alcohol dependence?

Answer 12

• Increased temp, pulse, resp rate, unintentional weight loss, D&V, tender abdomen, jaundice, bleeding, ascites (retention of fluid around abdomen)

Question 13

What drug is given in secondary care for alcohol withdrawal symptoms?

Answer 13

• A long acting benzodiazepine (diazepam)

Question 14

What is a condition that is caused by chronic alcohol misuse and what are the symptoms?

Answer 14

• Wernickes encephalopathy: acute, rapid inflammation of the brain, lowers BP, temp = coma
• Confusion
• Nystagmus
• Memory disturbance
• Hypo thermia/tension

Question 15

What is given to treat Wernickes encepholapathy?

Answer 15

• Parenteral thiamine followed by PO thiamine

Question 16

How is alcohol misuse managed in primary care?

Answer 16

• Structured brief advice
• Extended brief intervention: HCPs received training, motivational interviews
• Psychological intervention: mental health
• Referral
• • prophylactic oral tx if malnourished: thiamine