Lecture 9 Alcohol use Flashcards Preview

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Flashcards in Lecture 9 Alcohol use Deck (18):

What percentage of Canadian adults consumer alcoholic beverages at least occasionally?

75% and 51% of that is beer


Alcohol use disorder

-AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using
-(meet any two of the 11 DSM criteria)


Alcohol use disorder demographic

-More common in males than females
-More common in younger people
-Affects any socio-economic background


What is AUD most comorbid with?

Depression, (Males: 60%, Females: 33%)


Treatment concerns regarding AUD?

-No gold standard
-Anyone can run a treatment center without credentials or scientific research to back it up
-Some options are too pricey- not covered by insurance
-Few programs report success rates


Key treatment targets for all treatments

-Increase motivation to change
-Increase capabilities or skills (skills training)
-Change cognitions that promote use
-Change reinforcers related to substance use
-Prevent relapse


Is there a difference in effectiveness between Motivational Interviewing, Cognitive Behavioural Coping skills, and 12 Step Facilitation therapy?

Few significant differences, most patients did not maintain complete abstinence but all led to reductions in outcome variables.

-One matching characteristic: low-psychiatric severity patients has more abstinent days with 12-step


Motivational Interviewing

-An intervention that promotes motivation to change
-Therapist acts as a person of support, allowing client to make their own choices and arrive at their own conclusions


Key elements of Motivational interviewing

-Evocation (of internal desire for change)
-Acceptance and trust in the autonomy of the client


FRAMES of Motivational Interviewing

F: Feedback
R: personal Responsibility of client for change
A: clear Advice
M: Menu of options for client
E: Empathetic treatment
S: Self-Efficacy is increased/changed


Stages of Change (M.I)



Early sobriety strategies (CBT)

1. Stimulus control
2. Dealing with urges
3. Addressing Cognitive distortions about alcohol
4. Alternative/Distracting behaviours
5. Identifying Alternative ways to obtain reinforce
6. Drink refusal skills


12 step programs

-90 day induction period
-sponsors as mentors
-12 steps


Pharmacological Models

-Admit to residential/semi-residential treatment
-Little emphases on psychological or social interventions
-Drug replacement to ameliorate withdrawal


Chance of Relapse for AUD

2/3 or 66%


Lapse vs Relapse

A Laspe is a temporary blip (drinking on your bday)
A Relapse is a return to previous state (drinking every other day)


Two processes of relapse

1) Abstinence Violation Effect:: 'ahh what the hell' effect
2) Apparently Irrelevant behaviours


2 steps after a Lapse

1) Identify Stimuli that trigger cravings
2) Problem solve on how modify/avoid/resist