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Topic : Alcohol Use

CAGE Criteria

C = Have you flet you ought to Cut down on your drinking?
A = Have people Annoyed you by criticizing your drinking?
G = Have you ever felt bad or Guilty about your drinking?
E = Have you ever had a drink the first thing in the morning (Eye opener) to steady your nerves or get rid of a hangover?

Interpretation:
One 'yes' answer indicates hazardous drinking. Two or more 'yes' answers indicates abuse or dependence.

Criteria for At-Risk Drinking

Men > 14 drinks per week or >4 drinks per occasion
Female >7 drinks per week or >3 drinks per occasion

Criteria for Alcohol Abuse

Patterns of alcohol use in which 1 (or more) of the following 4 critieria are present within a year period

Recurent alcohol use reesulting in

  • Failure to fulfill major role obligations
  • Placing self and others in potentially hazardous situations
  • Legal problems

Continue alcohol use with persistent or recurrent social/interpersonal problems due to effects of alcohol
Adapted from DSM 4

Criteria for Alcohol Dependence

Pattern of alcohol use in which 3 (or more) of the following 7 criteria are present within a 12 hour period:

  • Physical tolerance (increased amounts are required for desired effect)
  • Withdrawal symtpoms whine substance is discontinued
  • Larger amounts of alcohol are used than intended
  • Unsuccessful efforts to control use
  • Much time and energy are spent in obtaining, using, and recovering from effects of alcohol
  • Many social work-related, and recreational activities are reduced because of alcohol use
  • Continued use in spine of knowledge that alcohol causes physical and /or psychological problem
Adapted from DSM 4

CBC = elevated MCV is marker of excessive use
GGPT = most sensitive screening test for long term heavy ETOH
AST/ALT = 2/1 suggestive ETOH induced liver disease

FRAMES for Brief Interventions

Feedback = tell patient about findings and their meaning
Responsibility = success for treatment is dependent on the patient
Advise = direct patient to quit or cut down
Menu = offer patient options to empower them in quitting
Empathic = show patient that your interest is sincere
Self-efficacy = physician assisted empowerment
Miller et al. Motivational Interviewing: Preparing people to change addictive behaviour.

 

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This page was create for our staff and students. Its sole purpose is to stimulate thought. It is not meant to replace nor substitute in any way for the care of a physician or appropriate expert.

Webmaster: John W. Norris, III, M.D.

All contents copyright © 1998-2004 John W. Norris, III, MD.  All rights reserved
All information within this site subject to change without notice.

Revised March 16, 2004.