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Alcohol Dependence Notes

This is a sample of our (approximately) 3 page long Alcohol Dependence notes, which we sell as part of the Psychiatry Notes collection, a MBChB (hons) (1st) package written at University Of Leicester in 2014 that contains (approximately) 43 pages of notes across 14 different documents.

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Alcohol Dependence Revision

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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 >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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