Medications pharmacotherapy used as adjuncts to counseling techniques and biopsychosocial, educational, and spiritual therapies are an increasingly important part of a comprehensive treatment approach for alcohol dependence. Expanding knowledge of how medications may interact with and complement counseling will help the addiction counseling community optimally coordinate care of patients with other treatment providers. Thus, this article series not only provides the latest efficacy and safety data on these medications, it also explores how we can build better relationships among addiction professionals and medication prescribers.
Relationship Case study alcohol dependence alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: BMC Public Health Previous research has shown a gradient in the risks of ill Case study alcohol dependence by SES such that those with low personal or neighbourhood SES are much more likely to die or suffer from a range of diseases, including those related to alcohol e.
For example, males and females in the most socioeconomically deprived neighbourhoods of the UK have been estimated to be two to three times as likely to die from an alcohol-related condition than their counterparts living in the least deprived Deacon et al.
However, analysis of alcohol use behaviours suggests that there is little difference in consumption between these types of areas. We have termed the observation that deprived populations that apparently consume the same or less alcohol than more affluent populations suffer far greater levels of harm the alcohol harm paradox.
A number of explanations are hypothesised as to why this might occur, including: Under-reporting or inaccurate reporting of alcohol use in low SES groups, or by heavy drinkers in low SES groups, compared to less deprived groups.
Differences in drinking patterns between SES groups, rather than differences in intake e. Compounding due to clustering of unhealthy behaviours and associated risk factors in more deprived neighbourhoods. Differential access to, and quality of, health services and other neighbourhood resources such as alcohol outlets.
A poverty gradient through which unhealthy heavy drinkers move into poverty through loss of employment. This research explored some of these explanations in order to determine whether the alcohol harm paradox was robust, and to try and understand how it arises. Methods The research proceeded through a number of interlinked activities: Firstly, we undertook a systematic reviews and meta-analysis of evidence in order to examine the relationship between SES factors and alcohol-related harm.
Review questions focused on i alcohol related disease; ii alcohol related mortality and morbidity. We then reviewed relevant evidence in order to try and develop Alcohol Attributable Fractions AAF; the proportion of a disease or injury that could be prevented if exposure to alcohol was eliminated for specific drinking patterns and SES.
Secondary analysis of existing data: After reviewing a number of existing population surveys we chose to reanalyse the General Lifestyle Survey GLF in order to explore the relationship between i drinking behaviours, individual SES, and neighbourhood SES; ii heavy drinking, individual SES, and neighbourhood SES; iii beverage preference, individual SES and neighbourhood SES; and iv drinking behaviour, self-rated health, health service use, and neighbourhood deprivation.
Development of a new method to assess self-reported alcohol use in general population surveys: We subsequently undertook a telephone survey of the English adult population. Data was obtained from individuals By comparing estimates of typical and combined alcohol use we were able to determine whether underreporting was related to SES and other factors.
Findings Our systematic literature review showed differing relationships between a range of alcohol-attributable conditions and socioeconomic indicators. A key consideration of the review was the small number of published studies available that had explored the interaction between alcohol-attributable disease, socioeconomic status, and alcohol use.
However, it was possible to conclude that low, relative to high socioeconomic status, was associated with an increased risk of head and neck cancers, strokes, hypertension, and in individual studies, with liver disease and preterm birth. Conversely, risk of female breast cancer tended to be associated with higher socioeconomic status.
These findings remained after controlling for a number of known risk factors for these diseases and other potential confounding factors. In studies that controlled for alcohol use, addition of this variable to the statistical models explained a substantial proportion of the difference in risk between high and low SES groups for stroke risk, preterm birth, and in combination with smoking, head and neck cancer risk.
This suggested that for these conditions at least, alcohol use was an important contributory factor in the association between SES and disease.
Our meta-analysis examined the association between SES, alcohol related deaths and hospital admissions. We found that when SES was determined on the basis of occupation or education, individuals of lower SES were almost twice as likely to experience alcohol related death or hospitalisation.
Examining men and women separately, compared to those of higher SES classification, men in lower SES classifications were also almost twice as likely to experience alcohol-related death or hospitalisation as women. This would have allowed a better understanding of whether the alcohol harm paradox was partly due to differences in AAF coefficients between SES groups.
In other words, whether, for a particular condition e. This would have helped in understanding the impact of interventions and policy options that aim to reduce health inequalities caused by alcohol.In this final article, Carlo C. DiClemente, PhD, ABPP, presents case studies that illustrate how medications have helped individuals break their dependence on alcohol.
We would like to hear from you on what you thought of this article series, and on how the emergence of medications to treat alcohol dependence has affected your organization and your patients. Most ethanol (CH 3 CH 2 OH) is metabolized in the cell cytosol of the liver (and to a lesser extent kidney, lungs and other tissues) by the enzyme alcohol dehydrogenase to produce acetaldehyde (CH 3 CHO), with NAD as the hydrogen acceptor..
About 50% of drugs (including alcohols) are metabolized by a family of liver endoplasmic reticulum (microsome) enzymes known as CYtochrome Ps, (CYP, so. A Case Study on the Dependence of BP's IT Organization Words | 2 Pages.
1. The case mentions the dependence of BP’s IT organization on external contractors. Patient case study – alcoholism This is an excerpt from Practical Pharmacology in Rehabilitation by Lynette Carl, Joseph Gallo, and Peter .
A Case of Alcohol Abuse. The doctor inquires regularly about her alcohol habit and believes that the patient is mostly truthful about her bouts of drinking and times of abstinence.
One week ago, her husband and a daughter called to request time to “talk about mother.” The husband related that his wife had resumed daily drinking (about 1.
For people who suffer from severe alcohol dependence and major alcohol withdrawal syndrome, a marijuana maintenance approach which replaces alcohol with cannabis may be the most successful treatment paradigm.