Table of Contents IntroductionAlcohol useSocial effectsDependenceMood and riskRest of historyWant to test yourself?Now try some OSCE stations! Introduction Wash hands Introduce self Ask Patient’s name, DOB and what they like to be called Explain and obtain consent Alcohol use Current use What: how much (units = %abv. x litres volume), type of alcohol When: times of day, days of week, continuous/binge Where: pub, home alone, work Why: social, underlying issues (family, relationships, depression etc.), availability, stress, psychiatric problems Past (alcohol timeline) 5 year intervals – any personal correlations? Ever tried to cut down – what happened? Treatments and detoxes and how they went Relapse reasons Units by alcoholic drink type Social effects Effect on self (e.g. injuries, medical conditions) Effect on family/friends Effect on work Effect on finances Any trouble with police related to alcohol Driving Dependence Physical dependence Tolerance Autonomic withdrawal symptoms: tremor, sweating, nausea/vomiting, palpitations Neurological withdrawal symptoms: agitation, headache, hallucinations, seizures, insomnia Psychological dependence Compulsion/persistent desire to drink Lots of time spent drinking Given up activities/hobbies or spending less time with family/friends Mood and risk Effect on mood Assess risk of self harm/suicide Rest of history Past psychiatric history: any disorders including anxiety and depression PMHx: physical health problems due to alcohol/drugs (e.g. peptic ulcer disease, liver disease, upper GI bleeding, memory loss) DHx FHx: family alcohol use SHx: recreational drug use, smoking, family/living/working situation Want to test yourself? What help is available to people struggling with alcohol use? Oops! This section is restricted to members. A patient tells you they drink 3 bottles of wine a day. What is their approximate weekly alcohol unit intake? Oops! This section is restricted to members. What are the options for undertaking an alcohol detox? Oops! This section is restricted to members. Now try some OSCE stations! Alcohol-related problems Pancreatitis There are lots more where these came from!
