Brief Intervention and Assessment on a Patient with Alcohol Misuse - Essay Example

Brief intervention and assessment on a patient with alcohol misuse An important matter of public health concern all around the globe is alcohol misuse. Alcohol abuse is not only associated with health problems but it is also an underlying reason for legal issues as well as socioeconomic problems. It is an important cause of accidents and thus it does not only bring harm to the abuser but to the other people as well. In the year 1995, in Canada, the mortality rate due to alcohol misuse was 22.2 per 100,000 person-years. In the year 2002, the mortality rate in the United States was 7.0 per 100,000 person years (Dhalla and Kopec 33). In the year 2000 alone, it was estimated in the United States that alcohol misuse was the cause of 100,000 deaths per year (Woolard, Cherpitel and Kathleen 146). In the United Kingdom, 40000 deaths per year per due to alcohol abuse as per the estimations of the year 2008. In England, it has been calculated that 10 million people consume alcohol above the limits of alcohol that are permitted. Furthermore, this consumption of alcohol is responsible for incurring costs as high as ?2.7 billion on the NHS in UK (Alcohol Concern 4, 13). The risks to human health accompanied with the high mortality associated with alcohol abuse as well as the high costs incurred upon the health care system have led to make alcohol misuse an issue of global concern. The high numbers of alcohol abusers have made it essential for the healthcare providers to understand a brief intervention and assessment plan for a patient with alcohol misuse. Alcohol abuse poses serious health risks. This can be understood by the fact that it has been marked to be the second most important risk factor associated with cancer with smoking being labelled as the first one (Alcohol Concern 6). Furthermore, alcoholism has also been marked to be one of the commonest psychiatric conditions and dependency upon alcohol is known to occur in approximately 8 to 14% of the people. Thus, the assessment and intervention strategies in alcohol abuse are of utmost importance. The assessment of alcohol misuse is important because it is often missed by the medical professionals. This is owing to several factors. The hesitation of the patient in sharing information is the most important factor. This leads to many difficulties which include misinformation with regard to pathologies in the patient as well as wrong medicinal prescriptions. Furthermore, medical health professionals treat the patients according to their symptoms without recognizing alcohol as the cause for the symptoms which can be problematic. It is important for this reason that symptoms and tests for assessment of patients with alcohol abuse are known (Enoch and Goldman 441). The medical facilities where a patient with alcohol abuse comes should be checked by the medical staff. They should send the patient for specific interventions and detailed assessment and if they are unsure of the diagnosis, the patient should further be referred for assessment. AUDIT (Alcohol Use Disorders Identification Test) is the first step in the assessment of the patients and when the score in this test is above 15, a comprehensive assessment becomes compulsory. AUDIT is considered to be the most important and accurate assessment questionnaire for assessing alcohol abuse (NICE 8, Enoch and Goldman 443). The patient should be examined thoroughly as well to be sure of the fact that patients who have misused alcohol are not missed. Symptoms of the patient with alcohol misuse include sweating, increased heart rate, depressive episodes, changes in mood, nausea, sleeplessness, blackouts, seizures as well as tremors. Gastrointestinal tract symptoms may also be present which include diarrhoea, feeling of fullness and dyspepsia. Furthermore, patients may also complain of loss of memory and they do not have a steady gait and may also have erectile dysfunction. The signs of alcohol misuse include abuse of other drugs as well as unpredicted reactions of medicine. The patient may have a low nutritive status as well as a history of constant falls. Accidental occurrences as well as suicidal tendencies are also high in alcohol abusers. These signs and symptoms should properly be checked in the patient and it should be ensured that patients of alcohol misuse are not misdiagnosed and treated for their presenting symptoms rather than the main underlying cause (Enoch and Goldman 442). Screening tests should be present in the healthcare facilities to overcome the problem of alcohol misuse which is an issue of public health concern. A range of laboratory tests can assist in a definite diagnosis of a patient with alcohol abuse. In patient with confusing symptoms, these tests can be run. In a patient who can be suspected with presenting in the medical facility following a recent episode of alcohol misuse, a breath analysis as well as a blood alcohol test can be run for confirmation. To confirm the fact that the patient has been drinking heavily, Gamma-glutamyltransferase and carbohydrate-deficient transferrin levels can be checked and elevated results confirm the doubt. This is particularly true for males. Mean corpuscular volume as well as high density lipoproteins and triglyceride levels are also elevated. Damage to the liver is one of the very serious side effects of alcohol misuse. This can be confirmed by checking the levels of Serum glutamic oxaloacetic transaminase level, alkaline phosphatase level and alanine aminotransferase level. The laboratory diagnostic tests confirm of the fact that the patients have presented with alcohol misuse and thus these patients should be referred for detailed assessment followed by intervention (Enoch and Goldman 442). The detailed assessment includes features which include a thorough history of clinical problems as well as an assessment of the drinking habits. The patient should be questioned with regard to the quantity of alcohol that he consumes along with the timings and patterns in which he consumes it. A family member and a friend should also be questioned to improve reliability. Dependence as well as the problems associated with the intake of alcohol should be asked. History of other drug abuse should be taken. Social as well as psychological issues of the patients should also be assessed for the purpose of understanding the kinds of interventional strategies needed for the patient (NICE 8). Brief intervention is used for the patients who present with alcohol abuse. The success of this interventional strategy which is mainly a form of counselling is useful for patients who do not have any associated social problems or who are to be further referred for enrolling in alcohol abuse correction programs. It is a short counselling intervention for patients. The brief intervention program for the patient is based mainly upon four sessions. This can be carried out in a primary health care facility. The first session is based upon an appointment with the physician. This is a short appointment of fifteen minutes where the physician asks important questions with regard to alcohol misuse and provides guidance to the patient. The physician assesses the amount as well as regularity of alcohol drinking. This is followed by asking the patient with regard to the reasons of the consumption of alcohol. The physician then explains the hazardous effects that are associated with alcohol misuse and how it may negatively affect the living of the patient. In this manner, the physician takes the patient in confidence and gives an open advice to the patient to either quit alcohol drinking or decrease the amount that he drinks. This should be followed by discussing with the patient the choices and ways to decrease the drinking habits. Schedules are designed to suit the patient to assist in decreasing alcohol intake. This is followed by a contract where the patient and the physician set a particular goal that is to be met. Methods to overcome this habit along with behavioural support are provided and the physician provides for optimistic views to the patient. A second session is booked after two weeks which is mainly a telephonic conversation with the clinic nurse. This session is for follow up purposes as well as further strengthening the patients will to support the goal set. The next session is again with the physician after two weeks which is also of fifteen minutes. This serves the same purpose of motivating the patient. The last session is again through telephone with the clinic nurse for checking the patient. Alcohol misuse is a major issue and patients should be tackled in a manner where their physiological as well as psychological dependence is managed (Enoch and Goldman 444,445). Alcohol misuse is an issue of importance for the public health department all across the globe. It is a cause of many deaths across the major countries of the world. It leads to health issues as well as accidents and incidents of violence. Medical health professionals should be aware of the assessment strategies and the brief intervention plan should be understood for helping the patients. Assessment should be based on a detailed history as well as laboratory investigations. Brief intervention is to help the patient in either decreasing the intake of alcohol or abstaining from drinking totally. Works Cited Alcohol Concern. “Making alcohol a health priority. Opportunities to reduce alcohol harms and rising costs.” Lundbeck. Alcohol Concern. 2011. Web. 7 Apr. 2013. Dhalla, S, and JA Kopec. "The Cage Questionnaire for Alcohol Misuse: a Review of Reliability and Validity Studies." Clinical and Investigative Medicine. Me?decine Clinique Et Experimentale. 30.1 (2007): 33-41. Print. Enoch, MA, and D Goldman. "Problem Drinking and Alcoholism: Diagnosis and Treatment."American Family Physician. 65.3 (2002): 441-8. Print. NICE.Alcohol-use Disorder: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence. London: National Institute for Health and Clinical Excellence, 2011. Print. Woolard, Robert, Cheryl Cherpitel, and Kathleen Thompson. "Brief Intervention for Emergency Department Patients with Alcohol Misuse: Implications for Current Practice."Alcoholism Treatment Quarterly. 29.2 (2011): 146-157. Print. Read More