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Flashcards in Substance Abuse Deck (38)
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1
Q

Risks of alcohol use/abuse

A

accidents, trauma
cirrhosis, alcoholism
cancers of the mouth, esophagus, liver, breast
cardiomyopathy, HTN, arrhythmias

2
Q

Binge drinking numbers

A

Men: 5 drinks in 2 hrs
Women: 4 drinks in 2 hrs

3
Q

Risks of drinking while pregnant

A

-Fetal alcohol syndrome

4
Q

What amount of alcohol is safe for pregnant women?

A

No amount of alcohol is safe for pregnant women

5
Q

Pocket Guide for Alcohol Screening and Brief Intervention

A

Step 1 - ask about alcohol use
Step 2 - assess for use disorders
Step 3 - advise and assist
Step 4 - follow-up and continued support

6
Q

Step 1 questions

A

-Do you sometimes consume beer, wine, beverages?
-How many times in the past year have you had 5 or 4 or more drinks/day?
On average, how many days a week do you have an alcoholic drink?
-On a typical day, how many drinks do you have?
calculate WEEKLY AVERAGE

7
Q

How to calculate weekly average of drinks

A

day/week x drink/day

8
Q

Step 2 questions

A

In the past year, has you drinking repeatedly caused risk of harm, relationship trouble, role failure, run-ins with the law

9
Q

How do you indicate alcohol abuse in step 2?

A

If yes to one or more of the questions

10
Q

How do you indicate alcohol dependence?

A

3 or more of:

  • not been able to cut down/stop
  • not been able to stick to drinking limits
  • show tolerance (need more to have same effect)
  • shown signs of withdrawal
  • kept drinking despite problems
  • spent a lot of time drinking
  • spent less time on other matters
11
Q

If the patient is not alcohol dependent or alcohol abuser, what are they?

A

At risk drinking

12
Q

In step 3, what should you do for the at-risk drinkers?

A

State conclusions and recommendations

-Gauge readiness to change

13
Q

What model do you use to assess readiness to change?

A

Transtheoretical model

14
Q

What do you do if the patient is ready for change?

A

Help set a goal, agree on a plan, provide educational materials

15
Q

What do you do if the patient is not ready for change?

A

Restate concerns, address barriers to change, encourage reflection, reaffirm willingness to help them

16
Q

In step 3, what do you do for the alcohol-use disorders?

A
  • State conclusions
  • Negotiate a drinking goal
  • Consider evaluation by an addiction specialist
  • Recommend a mutual help group
  • Arrange follow up
17
Q

For those who are alcohol dependent, what should you consider for them?

A

Medication

Medically managed withdrawal (detoxification)

18
Q

What do you check in step 4?

A

Was the patient able to meet and sustain their goal?
If YES - reinforce and support continued adherence
If NO - acknowledge that change is difficult, address coexisting problems, continue to support the patient

19
Q

Uncomplicated alcohol withdrawal

A

Shortly after cessation, peaks at 2nd day, improves by 4th or 5th day

  • coarse tremors of hands, tongue, eyelids
  • anorexia, malaise
  • autonomic hyperactivity (tachycardia, sweating, elevated BP)
  • headache, hallucinations, insomnia, anxiety, irritability
20
Q

Withdrawal delirium

A

Delirium Tremens - occurs within a week of cessation

  • coarse irregular tremors
  • marked autonomic hyperactivity
  • vivid hallucinations and elusions, agitated behavior
  • fever
21
Q

CIWA scale for Alcohol rates what on a range from 0-7?

A

Rate nausea, vomit, tremors, anxiety, paroxysmal sweats, tactile disturbances, auditory disturbances, visual disturbances, headache from 0-7

22
Q

CIWA scale for Alcohol rates what on a range of 0-4?

A

Orientation and clouding of sensorium

23
Q

What is the max score for the CIWA scale?

A

67

24
Q

At what score is the patient at a severe withdrawal?

A

Over 20

25
Q

At what score is the patient at mild withdrawal?

A

Less than 15

26
Q

What sort of abuse often occurs in conjunction with other substance use and abuse?

A

Tobacco abuse

27
Q

Smoking history questions

A
Current or past?  
How many packs/day?
How many years?
Calculate pack years
When did you quit smoking?
28
Q

What is the most commonly used drug/abused

A

Marijuana

29
Q

Subjective questions for drug abuse

A
  • which of the following substances have you used in your life time?
  • in the past 3 months, how often have you used this substance? How often do you have a strong desire to use it? How often has your use led to health, legal, social, or financial problems? How often have you failed to do what was normally expected from you?
  • has a friend or relative or anyone else ever expressed concern about your use?
  • have you ever tried and failed to control, cutdown, or stop using?
30
Q

What scale is used to assess drug withdrawal?

A

COWS

31
Q

In COWS, what do you rate on a scale of 0-4?

A

Resting pulse, sweating, bone/join ache, runny nose, tremors, yawning, anxiety, irritability

32
Q

In COWS, what do you rate on a scale of 0-5?

A

Restlessness, pupil size, GI upset, gooseflesh skin

33
Q

Max COWS score

A

48

34
Q

Mild withdrawal COWS score

A

less than 5 -12

35
Q

Moderate withdrawal COWS score

A

13-24

36
Q

Moderately severe withdrawal COWS score

A

25-36

37
Q

Severe withdrawal COWS score

A

greater than 36

38
Q

the 4 A’s of recommendations for drug abuse

A

Assist - provide medical advice
Assess - determine readiness to change
Assist - offer help based on level of readiness
Arrange - refer for speciality assessment and or drug treatment as necessary