1,721,099 research outputs found
Drugs for alcohol dependence
Full text linkThere is good evidence for the use of pharmacological treatments to improve outcomes in patients with alcohol use disorders (AUD). The management of acute withdrawal should include a high risk of suspicion for Wernicke–Korsakoff Syndrome, necessitating treatment with parenteral high-potency B vitamins (Pabrinex®). Benzodiazepines in reducing doses should be used in conjunction with a continuing treatment plan after detox (detox). The relapse prevention medications acamprosate and naltrexone should be considered in all patients with moderate to severe alcohol dependence wishing to maintain abstinence. Disulfiram can be considered as a second-line treatment, but should be initiated by a specialist. Nalmefene has been shown to be effective in patients with mild dependence wishing to reduce their alcohol consumption. Baclofen has a temporary indication in France, and may have a role in patients with co-morbid liver disease and anxiety, but its efficacy remains unproven
Prehabilitation before surgery, alcohol's impact on clinical care and life after cardiac arrest
No full textPostgraduate education and training of medical doctors on prevention and management of disorders due to substance use and addictive behaviours
No full textUnderstanding resolution of deliberate self harm: qualitative interview study of patients' experiences
Full text linkOBJECTIVE: To explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services. DESIGN: Qualitative in-depth interview study. SETTING: Interviews in a community setting. PARTICIPANTS: 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview. RESULTS: We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness. CONCLUSION: Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate
Can student health professionals accurately estimate alcohol content in commonly occurring drinks?
No full textObjectives: Correct identification of alcohol as a contributor to, or comorbidity of, many psychiatric diseases requires health professionals to be competent and confident to take an accurate alcohol history. Being able to estimate (or calculate) the alcohol content in commonly consumed drinks is a prerequisite for quantifying levels of alcohol consumption. The aim of this study was to assess this ability in medical and nursing students.Methods: A cross-sectional survey of 891 medical and nursing students across different years of training was conducted. Students were asked the alcohol content of 10 different alcoholic drinks by seeing a slide of the drink (with picture, volume and percentage of alcohol by volume) for 30 s.Results: Overall, the mean number of correctly estimated drinks (out of the 10 tested) was 2.4, increasing to just over 3 if a 10% margin of error was used. Wine and premium strength beers were underestimated by over 50% of students. Those who drank alcohol themselves, or who were further on in their clinical training, did better on the task, but overall the levels remained low.Conclusions: Knowledge of, or the ability to work out, the alcohol content of commonly consumed drinks is poor, and further research is needed to understand the reasons for this and the impact this may have on the likelihood to undertake screening or initiate treatment.<br/
Joint symposium on mental health and addiction: A discussion, exchange and sharing of perspectives
No full textThis one-day symposium, held jointly by the UK Academy of Sciences and the Académie Nationale de Médecine1 in Paris, France, focused on the epidemiology and impact of both alcohol and cannabis addiction in young people in the UK and France.Young people were defined according to the United Nations approach as between the ages of 15 and 24 years. The symposium also provided an opportunity to discuss the public health and legal frameworks designed to help prevent or mitigate addictions, and the responses of healthcare systems in both countries.An overarching ambition of the symposium was to promote discussions to identify areas where lessons from one country may be applicable to the other, with the ultimate desire of highlighting ways in which addictions might be better treated in both countries.The following report summarises the presentations and discussions held at the meeting, and outlines some of the key themes to emerge. Notably, the report also presents the key evidence gaps and opportunities for future research that delegates agreed should be prioritised in order to improve responses to addiction in both the UK and France.It reflects the views expressed by participants at the meeting and does not necessarily represent the views of all participants, all members of the Steering Committee, the Academy of Medical Sciences or the Académie Nationale de Médecine.The Academy of Medical Sciences and the Académie Nationale de Médecine are most grateful to the steering committee for their work towards the development of the agenda, and on the day itself. Details of the steering committee members are provided in Annex 1
Alcohol use disorder and the liver
No full textAlcohol use disorders (AUD) cause a range of physical harms, but the major cause of alcohol-related mortality is alcohol-related liver disease (ALD), in some countries accounting for almost 90% of alcohol-related deaths. The risk of ALD has an exponential relationship with increasing alcohol consumption, but is also associated with genetic factors, other life-style factors and social deprivation. ALD includes a spectrum of progressive pathology, from liver steatosis to fibrosis and liver cirrhosis. There are no specific treatments for liver cirrhosis, but abstinence from alcohol is key to limit progression of the disease. Over time, cirrhosis can progress (often silently) to decompensated cirrhosis and hepatocellular carcinoma (HCC). Liver transplantation may be suitable for patients with decompensated liver cirrhosis and may also be used as a curative intervention for HCC, but only for a few selected patients, and complete abstinence is a prerequisite. Patients with AUD are also at risk of developing alcoholic hepatitis, which has a high mortality and limited evidence for effective therapies. There is a strong evidence base for the effectiveness of psychosocial and pharmacological interventions for AUD, but very few of these have been trialled in patients with comorbid ALD. Integrated specialist alcohol and hepatology collaborations are required to develop interventions and pathways for patients with ALD and ongoing AUD.</p
Update on the management of alcohol use disorders
No full textAlcohol use disorders (AUD) are common, particularly in patients attending mental health services. Clinicians are often hesitant to explore with patients their relationship with alcohol and the role that it has in their presenting complaint, despite being ideally placed to optimise on a ‘teachable moment’ and initiate treatment, where necessary. This article provides an overview of AUD and their identification and management options
'Mother's ruin'- why sex and gender differences in the field of alcohol research need consideration
No full textWe are particularly pleased that Alcohol and Alcoholism has dedicated this special collection to ‘Sex and Gender differences in Alcohol Use Disorder’. To date, a series of preclinical and clinical studies have tried to shed light on the similarities and differences in the field of alcohol research between men and women (Agabio et al., 2016a and 2017; Salvatore et al., 2017; McHugh et al., 2018; Ait-Daoud et al., 2019; Becker and Chartoff, 2019). However, our understanding of the complexities on this topic remains limited
- …
