Chapter 1: Addiction Medicine Part 2: Alcohol 2 Contact Hours
By: Katie Blair, PharmD, RPh Author Disclosure : Katie Blair and Colibri Healthcare, LLC do not have any actual or potential conflicts of interest in relation to this lesson. Universal Activity Number (UAN) : 0607-0000-22-039-H01-P Activity Type : Knowledge-based Initial Release Date : October 21, 2022 Expiration Date : October 21, 2025 Target Audience: Pharmacists in a community-based setting. To Obtain Credit: A minimum test score of 75 percent is needed to obtain a credit. Please submit your answers either by mail, fax, or online at EliteLearning.com/Book Questions regarding statements of credit and other customer ser- vice issues should be directed to 1-888-666-9053. This lesson is $14.95. Learning objectives After reading this monograph, pharmacists should be able to: Summarize the complications associated with alcohol use, including inebriation, withdrawal, and long term complications. Introduction Alcohol is one of the most widely used intoxicants in the world. In 2020, the National Survey on Drug Use and Health found that 50 percent of adults had used alcohol in the past month, and 22.2 percent reported drinking five or more drinks on one oc - casion in the past month (Substance Abuse and Mental Health Services Administration, 2021). The use of alcohol occurs on a spectrum, ranging from occasional drinking to regular, heavy use. Alcohol use disorder (AUD) is a medical condition characterized by an inability to control alcohol use despite adverse consequenc- es (National Institute on Alcohol Abuse and Alcoholism, 2021). Alcohol use disorder is a serious national health problem in the U.S. It is estimated that more than 14 million American adults and 414,000 adolescents (ages 12 to 17 years) had an AUD in 2019 (National Institute on Alcohol Abuse and Alcoholism, 2021). There are over 95,000 deaths every year that are directly attributed to
Colibri Healthcare, LLC is accredited by the Accredi- tation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Partici- pants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 2 contact hours (0.2 CEU) submit-
ted to CPE Monitor as early as within 10 business days after course completion and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 60 days of the event, credit cannot be claimed after that time. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
Describe current best practices for the treatment of alcohol withdrawal. Explain the screening, diagnosis and treatment of alcohol use disorder, including pharmacological and non- pharmacological treatment options. alcohol use, and the economic cost of alcohol use is astounding: Excessive alcohol use in the U.S. is said to cost nearly $250 billion annually. The majority of these costs (77 percent) are associated with binge drinking, that is drinking four or more alcoholic bev- erages per occasion for women, or five or more drinks for men (Centers for Disease Control and Prevention, 2019). In the U.S., AUD has a lifetime prevalence of approximately 29 percent. Despite the high prevalence and common complica- tions, alcohol use disorder is undertreated. Less than 10 percent of patients with a diagnosis in the past 12 months receive any treatment, and only around 6 percent of patients receive evi- dence-based care (Reus et al., 2018). There is a clear need for improvement in the treatment of this common condition, and this course serves to review the recognition, diagnosis, and treatment of alcohol use disorder.
SHORT- AND LONG-TERM EFFECTS OF ALCOHOL
Inebriation Alcohol is a central nervous system (CNS) depressant, causing decreased reaction time, motor coordination, and mental perfor- mance. After ingestion, it is swiftly absorbed into the bloodstream through the stomach and small intestine. From there, it is slowly metabolized by the liver. A healthy liver typically metabolizes one standard drink per hour, which is equivalent to 12 oz of 4 percent beer, 1.5 oz of 80-proof liquor, or 5 oz of table wine. The remain- ing alcohol continues to flow through the bloodstream until the liver is able to process it (UC Santa Cruz, 2019). The amount of alcohol present in the bloodstream determines the intensity of its effect on the body. Blood alcohol concentra- tion, or the percent of alcohol in the bloodstream, increases as more drinks are consumed. Blood alcohol levels of 0.08 percent or higher are associated with mild balance, speech, and vision im- pairment. This concentration marks the legal threshold of driving under the influence in most states. Between 0.1 and 0.15 percent, motor coordination and balance are significantly affected, speech may be slurred, and major loss of balance can occur. Concentra-
tions of 0.16 to 0.3 percent indicate severe intoxication, causing symptoms such as confusion, nausea, vomiting, and needing assis- tance walking. Blood alcohol concentrations of 0.35 to 0.4 percent are associated with a loss of consciousness, and over 0.4 percent can cause a coma and increase the likelihood of death by respira- tory failure (Stanford University, 2021; UC Santa Cruz, 2019). A number of factors can impact a person’s response to alcohol consumption. The presence of food in the stomach can slow the absorption of alcohol; blood alcohol concentrations can be up to three times higher in a person with an empty stomach when compared to someone who ate a meal before drinking. In addi- tion, up to 50 percent of people of Asian descent are less able to metabolize alcohol because of an inactive liver enzyme (alcohol dehydrogenase) needed for metabolism, resulting in more rap- id intoxication, flushing, dizziness, nausea, headache, and rapid heartbeat with alcohol use. Gender can also significantly impact the effects of alcohol.
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