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Alcohol Dependence Notes

Medicine Notes > Psychiatry Notes

This is an extract of our Alcohol Dependence document, which we sell as part of our Psychiatry Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Psychiatry Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Alcohol Dependence Dependence
- Psychological o Intense drive or craving for substance whose effects the user feels are necessary for a sense of well-being
- Physical o Adaptive state - physical disturbance when drug is halted

Categorizing patients according to units of alcohol drank per week Normal At risk Binge drinker

Male <21 a week Female <14 a week Male >21 a week Female >14 a week Male >10 in one Female >7 in one session regularly session regularly Heavy drinker Male >50 a week Female >35 a week Problem drinker = alcohol has caused a problem to health > 1 month Dependence = 3 x symptoms over 12 months

Questions to ask in history
- What are they drinking?
- Drinking history (longitudinal drinking history since teenage years)
- UNITS (% x volume in litres)
- Timing of drinking (have to have a drink in the morning?)
- What has it cost them? (biopsychosocial)
- Insight into drinking Other
- Most recent drink - how many hours ago? (assess for withdrawal)
- Concomitant drug use
- Previous experience of withdrawal
- Medical/psychological disorders Full physical examination for withdrawal symptoms/symptoms of liver disease Bloods/ECG/CXR if indicated (prior to detox)

Clinical features of dependence Edwards and Gross Criteria Social
- Quantity (drinking increased amounts to stave off symptoms)
- Diminished variability (drinking the same thing all the time)
- Drink repertoire narrowed into complete abstinence + round the clock drinking (one or the other)
- Drinking despite consequences (social, society, family - what drinking has taken away) Psychological
- Reinstatement after abstinence (after detox if they go back to drink, will need the same high level to stave off withdrawal)
- Craving
- "Drink centredness" - won't go out/do anything unless alcohol is available Physical
- Tolerance

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