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Addiction Medicine


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Current Alcohol Use
at least 1 drink in the past month
Binge Use
5 or more drinks on same occasion at least once in the past month
Heavy use
5 or more drinks on same occasion at least 5 days in the past month
Age most likely to use illicit drugs
18-20 y/o
average age of smoking initiation
what drug has the highest addiction potential
(highest % of current users out of those who have of ever used)
what drug is the leading cause of death
nicotine followed by alcohol
One drink equivalent
= 12oz beer (5% ethanol)*
= 5oz wine (13% ethanol)*
= 1.5oz liquor (40% ethanol)*
= 20 mg/dl rise in blood alcohol conc. in 150lb person
at what rate does the liver metabolize Etoh
20mg/dl per hour
legal blood alcohol in CA
how many drinks does it take for that 150 lb person to reach .08
5 drinks in an hour and one drink every hour after that to maintain.
genetics of alcoholism
-60% concordance in MZ twins
-alcoholics tend to have noticed earlier on a higher EtOH tolerance
Diagnosis of Dependence: 3 “C’s”
Compulsion or Preoccupation
Loss of Control
Continued use in spite of adverse consequences
DSM-IV: Substance Dependence
Use chemical more of or longer than intended
Desire or unsuccessful effort to modify use
Time spent to obtain, use, or recover from chemical
Important activities reduced or given up
Chemical use continued despite knowledge of its adverse consequences
3 elements at any time within 12 months
DSM-IV: Remission
early vs. sustained
Early: 12 months or less
Sustained: >12 months
DSM-IV: Substance “Abuse”
Maladaptive pattern of use leading to significant impairment or distress
Symptoms have never met Substance Dependence criteria
C.A.G.E. Questions
Have you ever felt you ought to Cut down on your use of alcohol?
Have people Annoyed you by criticizing your use of alcohol?
Have you ever felt bad or Guilty about your use of alcohol?
Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?
Stages of Change & Strategies
Precontemplation--Raise doubts

Contemplation--Tip the balance

Preparation--Which is best course
Action--Help take steps to change
Maintenance--Help identify strategies
Relapse--Help prevent discouragement
The focusing on the needs of another at the exclusion of identifying/meeting needs of oneself.

Deck Info