ALCOHOL DEPENDENCY

1. Approach to the patient Rapport, empathy, and style

2. History of Dependence Syndrome

Strong desire to drink - you do not feel right without drinking/ you need a drink to start your day - DO YOU EVER REALLY CRAVE OR DESPERATELY WANT A DRINK? Difficulty in cutting down you try to stop but you cant - IS IT HARD TO STOP DRINKING, ONCE YOU HAVE STARTED? - DO YOU EVER FEEL THAT DRINKING IS OUR OF CONTROL? Tolerance need a larger amount to get drunk / you need to drink more and more to get the same effect - DO YOU NEED TO DRINK MORE LIKE YOU USED TO , TO GET THE SAME EFFECT? Withdrawal you got very shaky, sweaty, and anxious/tense few hours after your last drink - HOW DO YOU FEEL BEFORE YOUR FIRST DRINK OF THE DAY? - HOW DO YOU FEEL IF YOU HAVENT DRINK FOR A WHILE? - WHAT HAPPENS WHEN YOU STOP DRINKING? - HOW DO YOU MAKE YOURSELF BETTER? Lost interest in other types of activities. - IS SOUNDS LIKE ALCOHOL HAS BECOME ONE OF THE MOST IMPORTANT THINGS IN YOUR LIFE - ANYTHING YOU FEEL YOU MISS OUT BECAUSE OF IT? - HOW WOULD LIFE HAVE BEEN DIFFERENT IF YOU HADNT USE IT?

 Continue using despite the negative consequences. you carry on drinking despite the fact that it is interfering with your work, family and relationship. - HAS ALCOHOL CAUSED YOU ANY PROBLEMS OR DIFFICULITIES? -DOES IT AFFECT YOUR HEALTY? HAVE YOU EVER NEED TO SEE THE DOCTOR BECAUSE EOF IT? -HAS IF AFFECTED YOUR MEMORY OR MOOD? - HOW DOES IT AFFECTS YOUR STUDIES/WORK/RELATIONSHIP? - HAS IT GOT YOU INTO ANY TROUBLE? Narrowing of repertoire - less variation, use the same type of alcohol, and tend to drink in the same way and at the same time. - DO ALL YOUR DAYS SEEM TO HAVE THE SAME PATTERN? Reinstatement after abstinence

3. Effects on functioning, e.g. forensic, relationships, work

-HAS ALCOHOL CAUSED YOU ANY PROBLEMS OR DIFFICULITIES? -DOES IT AFFECT YOUR HEALTY? HAVE YOU EVER NEED TO SEE THE DOCTOR BECAUSE EOF IT? -HAS IF AFFECTED YOUR MEMORY OR MOOD? -HOW DOES IT AFFECTS YOUR STUDIES/WORK/RELATIONSHIP?

4. Asks about mood symptoms:Mood, sleep, appetite,

concentration, energy, anhedonia 5. Asks about suicidal ideation 6. Asks about other substances misused

1. most people use alcohol for enjoyment purposes. But some have may develop problem from it. In fact, they found that alcohol causes more problem than illegal drug such as heroin and cannabis. People use it as tranquilizer, and it is addictive and its causing many physical illness + admission to the hospital

2. Dealing with alcohol problems? Keeping a drinking diary you may be surprised on how much you drink. This can be a great motivation for you to start cutting down. Talk to someone open up about your problems, and do not be ashamed about your problems. Most good friends will be pleased to help you. Talk to your GP / local alcohol organizations If you feel you cannot stop because you feel very restless and get very shaky, your gp may help prescribing you some drug to relieve those symptoms. There is also, self-help groups such as alcoholic anonymous that may provide help. What is alcoholic anonymous? How much alcohol is too much? Some drinks are stronger than the others. The easiest way to work out how much we are drinking is to count the units of alcohol. I units 1 ml of alcohol the amount in a standar pub measure of spirits, halp pint of normal strength beer, or lrger, or a small glass of wince. Men 21 units per week.

 Women 14 units per week. Binge drinking - how much you drink at one time . (men not more than 8 units) (women , not more than 6 units) Binge drinking you can drink above the safe limit for one night but still remain within your safe limit for the week. There is some eveidence that, even couple of days of binge drinking, you may start to kill off brain cells. This was previously thought to only those who drank continuously for long periods of time. Binge drinking is also thought to associate with an increased risk of early death in middle man.