Implementation of Screening and Interventions for Unhealthy Alcohol Use. Dan Jonas, MD, MPH

Size: px
Start display at page:

Download "Implementation of Screening and Interventions for Unhealthy Alcohol Use. Dan Jonas, MD, MPH"

Transcription

1 Implementation of Screening and Interventions for Unhealthy Alcohol Use Dan Jonas, MD, MPH

2 Our team Shana Ratner, MD Colleen Barclay, MPH Julia Tompkins, MSW,LCSW-A Bailey Minish Tamrah Watson, MSN, RN, FNP Not pictured: Eve Schon, RN; Nancy McElveen, Patient Advisor Britta Starke, MSW, LCSW Scott Rose, MD Katie Doss, MD Garrett Thompson

3 Project Aim To implement and test an evidence-based system for delivery and tracking of high-quality screening and interventions for unhealthy alcohol use in our general internal medicine clinic» Aiming to screen 50% of all patients (N = 12,603) seen in our clinic during the year-long project

4 Why screen for unhealthy alcohol use?» Unhealthy alcohol use is 3 rd leading cause of preventable deaths among adults in the U.S.» Over 20% of U.S. adults drink more than the recommended daily, weekly, or per-occasion amounts.» The U.S. Preventive Services Task Force and other national organizations recommend screening adults for unhealthy alcohol use, and providing counseling for persons with risky drinking behavior.

5 Definitions of unhealthy alcohol use use Term Unhealthy alcohol use* Risky use* Alcohol use disorder (AUD), mild, moderate, or severe Definition Overarching term that includes risky drinking and alcohol use disorder. Consumption levels that increase the risk for health consequences. Consumption of alcohol above recommended daily, weekly, or per-occasion amounts. Use of alcohol that is characterized by presence of 2 of 11 DSM-5 criteria. *Jonas et al., May 2014; Jonas et al., 2012 DSM-5, American Psychiatric Association, 2013

6 Term Definitions of unhealthy alcohol use Definitions of unhealthy alcohol use Unhealthy alcohol use* Definition Men < 65: 4 drinks in a day and 14 per week All women, and men 65+: 3 drinks in a day and 7 per week Overarching term that includes risky drinking and alcohol use disorder. Risky use* Alcohol use disorder (AUD), mild, moderate, or severe Consumption levels that increase the risk for health consequences. Consumption of alcohol above recommended daily, weekly, or per-occasion amounts. Use of alcohol that is characterized by presence of 2 of 11 DSM-5 criteria. *Jonas et al., May 2014; Jonas et al., 2012 DSM-5, American Psychiatric Association, 2013

7 Definitions of unhealthy alcohol use use Term Unhealthy alcohol use* Risky use* Alcohol use disorder (AUD), mild, moderate, or severe Definition Overarching term that includes risky drinking and alcohol use disorder. Consumption levels that increase the risk for health consequences. Consumption of alcohol above recommended daily, weekly, or per-occasion amounts. Use of alcohol that is characterized by presence of 2 of 11 DSM-5 criteria. *Jonas et al., May 2014; Jonas et al., 2012 DSM-5, American Psychiatric Association, 2013 e.g., drinking more than intended, craving, tolerance, withdrawal, continued use despite problems

8 Easier said than done» National data show that less than a third of patients are asked about alcohol use by their primary care providers, and less than 20% of adults report ever discussing it with a health care professional.» After implementing the new electronic health record, our practice did not have a system to screen for unhealthy alcohol use.

9 Flow of Process No Document. Screen again in 5 years. Nurse asks patient, Do you sometimes drink beer, wine, or other alcoholic beverages? Yes Nurse asks, How many times over the past year have you had 4 (for women and 65) or 5 (for men <65) drinks in a day? None Document. Screen again in 12 months. Counseling Risky drinking 1 times Nurse asks patient to complete AUDIT Provider reviews and scores AUDIT AUD likely Goal assessment Counseling Shared decision making about treatment options Referral

10 Quality Improvement Approach Built to resemble depression screening workflow To test protocols, we used low-tech, rapid cycle PDSAs before launching any permanent Epic tools» Pilot protocols with a limited number of providers and staff» Flag patients eligible for screening in the clinic schedule» Develop a temporary Epic tool (Dot Phrase) for screening» Develop paper-based decision support tools and provider Dot Phrases to guide assessment, counseling, or referral of patients with positive screens

11 Positive unintended consequences» Nurse familiarization with dot phrases» Closer relationship between GIM and the Alcohol & Substance Abuse Program (ASAP)» Updated an extensive list of resources in NC for people with AUD

12 Nurse Dot Phrases

13 New Epic tools: Nurse BPAs Prevention, Alcohol Screening: No initial alcohol screen or AUDIT documented in the past year. Click Doc Flowsheet to administer screen and document results. Alcohol Incomplete Screen: No AUDIT documented after patient screened positive on initial screen. Provide paper AUDIT and document results.» Visit-based reminders» Data entry in Flowsheets (searchable in EHR databases)

14

15

16

17

18

19 Provider Support for Counseling» Guidance for behavioral counseling interventions» Paper versions in rooms» Now also available for providers in dot phrases (developed by Scott Rose during QI month) What exactly is one drink?.imcalcoholavs

20

21 Mean rate = 80%

22 Mean rate = 42%

23 Celebrating achievements

24 Sustainability plan» The nurse BPAs will help ensure sustainability of the screening step Volume of screenings will decrease over time, e.g., BPA suppressed 5 years for nondrinkers» Streamlining and automating data collection» Physician Leadership in Quality & Safety Scholarly Concentration Garrett Thompson, MD/MPH student

25 Sustainability plan: Provider BPA and SmartSet

26 Sustainability plan

27 Key challenge: Competing demands New project designed to» Test screening via MyChart» Offer those with positive screens a virtual counseling intervention» Deliver information to providers Arlene Chung Co-PI

28 Thank you!

29 Lessons learned» We can successfully screen our patients» We were able to refine protocols and train staff, using low tech approaches, before making changes in Epic» Multiple positive unintended consequences Nurse familiarization with dot phrases Closer relationship between GIM and the Alcohol & Substance Abuse Program (ASAP) Updated an extensive list of resources in NC for people with AUD

30 Adults who have had at least one drink of alcohol within the past 30 days Percentage of respondents reporting Yes in 2014 Crude Prevalence (%) Data Source: Behavioral Risk Factor Surveillance System (BRFSS) 30

31 Binge drinkers (males having 5 drinks on one occasion, females having 4 drinks on one occasion) Crude Prevalence (%)

32 Heavy drinkers (adult men having more than two drinks per day and adult women having more than one drink per day) Percentage of respondents reporting Yes in 2014 Crude Prevalence (%) Data Source: Behavioral Risk Factor Surveillance System (BRFSS) 32

33 The Alcohol Use Disorders Test (AUDIT) Please circle your answer for each question: Points per response How often do you have a drink containing alcohol? Never Monthly 2 to 4 times a month 2. How many drinks containing alcohol do you have on a typical day when you are drinking? 3. How often do you have 5 or more drinks on one occasion? Never Less than monthly 2 to 3 times a week 4 or more times a week 1 or 2 3 or 4 5 or 6 7 to 9 10 or more Monthly Weekly Daily or almost daily 4. How often during the last year have you found that you were not able to stop drinking once you had started? Never Less than monthly Monthly Weekly Daily or almost daily 5. How often during the last year have you failed to do what was normally expected of you because of drinking? Never Less than monthly Monthly Weekly Daily or almost daily 6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? Never Less than monthly Monthly Weekly Daily or almost daily 7. How often during the last year have you had a feeling of guilt or remorse after drinking? Never Less than monthly Monthly Weekly Daily or almost daily 8. How often during the last year have you been unable to remember what happened the night before because of your drinking? Never Less than monthly Monthly Weekly Daily or almost daily 9. Have you or someone else been injured because of your drinking? No Yes, but not in the last year Yes, during the last year 10. Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down? No Yes, but not in the last year Yes, during the last year

34 DSM-5 diagnostic criteria for alcohol use disorder Severity: mild, 2-3 criteria; moderate, 4-5 criteria; severe, 6 criteria. 1 Alcohol is taken in larger amounts or over a longer period than intended. 2 Persistent desire or unsuccessful efforts to cut down or control alcohol use. 3 A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. 4 Craving, or a strong desire or urge to use alcohol. 5 Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. 6 Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. 7 Important social, occupational, or recreational activities are given up or reduced because of alcohol use. 8 Recurrent alcohol use in situations in which it is physically hazardous. 9 Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. 10 Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect. (b) A markedly diminished effect with continued use of the same amount of alcohol. 11 Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for alcohol. (b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms. Unlike DSM-III and DSM IV, DSM-5 (American Psychiatric Association, 2013) describes a single alcohol use disorder category measured on a continuum from mild to severe, and no longer has separate categories for alcohol abuse and dependence. Diagnosis of alcohol use disorder requires at least 2 of the 11 criteria listed.

35 Care Team Member and Patient Story From Julia George, clinic social worker The tools we ve developed have facilitated discussion of options for AUD counseling and treatment Julia described a story where the tools helped her and the PCP more efficiently discuss options and determine the plan of care Ultimately decided on inpatient treatment After detox in hospital, patient was referred to UNC ASAP, has attended follow-up appointments, and has maintained sobriety since discharge Julia noted that when she is not available to meet with patients in clinic, the referral information developed in our project allows resources to be delivered in a timely manner after counseling, when patients are likely to be more receptive

36 HELPING PATIENTS WHO DRINK TOO MUCH Introduction (cont d) How Much Is is Too Much? The Guide was written for Individual Drinking primary care becomes responses and mental too to much health alcohol when vary it Drinking clinicians. Causes at or It lower elevates is produced levels the may risk by the for be problematic alcoholrelated Institute problems, on many on factors; Alcohol for example depending National Abuse Complicates Patient s and Alcoholism age management (NIAAA), of other health a component problems Co-existing of the conditions, National and There Institutes Use are of increased medication Health (NIH), risks with for alcoholrelated guidance problems from physicians, for nurses, Note: advanced The practice U.S. nurses, Surgeon General urges abstinence physician Men <65 assistants, who drink from drinking and > 4 clinical standard drinks in a day for women researchers. (or >14 per week) and who All women are or and may men become 65 who pregnant. drink > 3 standard drinks in a day (or > 7 per week) #

37 WHAT S A STANDARD DRINK? What s a Standard Drink? (page 24) In the U.S., a standard drink is any drink that contains about 14 grams of pure alcohol (about 0.6 fluid ounces or 1.2 tablespoons). #

38 Prevalence Among American Physicians % with symptoms of alcohol abuse/dependence Adapted from Oreskovich et al., 2014, Am J on Addictions *AUDIT-C score 5 (men) or 4 (women)

39 Health problems Epidemiologic literature consistently relates high average alcohol consumption and heavy peroccasion use to an increased risk of Cancers (oral cavity, esophagus, larynx, colon, rectum, liver, and breast) Gastrointestinal problems, e.g., liver cirrhosis, pancreatitis, gastritis, ulcers Cardiovascular problems, e.g., heart disease, hypertension, cardiomyopathy, stroke Mental health problems: e.g., depression, suicide, anxiety, cognitive impairment Preterm birth complications, fetal alcohol syndrome Injuries and violence Mortality 39

40 Condition Neoplastic conditions (cancer site) 25 g/day (1.8 drinks/d) RR (and 95% CI) a 50 g/day (3.6 dr/d) 100 g/day (7.3 dr/d) Oral cavity and pharynx 1.86 ( ) 3.11 ( ) 6.45 ( ) Esophagus 1.39 ( ) 1.93 ( ) 3.59 ( ) Colon 1.05 ( ) 1.10 ( ) 1.21 ( ) Rectum 1.09 ( ) 1.19 ( ) 1.42 ( ) Liver 1.19 ( ) 1.40 ( ) 1.81 ( ) Breast 1.25 ( ) 1.55 ( ) 2.41 ( ) Non-neoplastic conditions Coronary heart disease 0.81 ( ) 0.87 ( ) 1.13 ( ) Ischemic stroke 0.90 ( ) 1.17 ( ) 4.37 ( ) Hemorrhagic stroke 1.19 ( ) 1.82 ( ) 4.70 ( ) Liver cirrhosis 2.90 ( ) 7.13 ( ) ( ) Chronic pancreatitis 1.34 ( ) 1.78 ( ) 3.19 ( ) Injuries and violence 1.12 ( ) 1.26 ( ) 1.58 ( ) a reference: non-alcohol drinkers; adjusted estimates Using 13.7gm per drink: 25g=1.8 drinks; 50g=3.6 drinks; 100g=7.3 drinks; 41.1g = 3 drinks; 54.8g = 4 drinks; 95.9g = 7 drinks 40 Corrao et al, Alcohol Consumption and Risk of 15 Diseases. Preventive Medicine, 2004

41 Relationship of all-cause mortality to usual alcohol intake in standard drinks per day based on pooled results of 14 cohort studies Alcohol intake (drinks per day) None Men RR (95% CI) ( ) 0.84 ( ) 0.93 ( ) 1.01 ( ) 1.06 ( ) 1.20 ( ) 1.37 ( ) Women RR (95% CI) ( ) 0.94 ( ) 1.13 ( ) 1.33 ( ) 1.47 ( ) 1.47 ( ) 1.58 ( ) CI=confidence interval; RR=relative risk Holman, English, Milne et al,

42 Significant increased RRs at 25g/day 13.7g of alcohol is 1 drink (often rounded to 14) Corrao et al, Alcohol Consumption and Risk of 15 Diseases. Preventive Medicine,

Chapter 7. Screening and Assessment

Chapter 7. Screening and Assessment Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions

More information

Module Three Screening and Assessment V

Module Three Screening and Assessment V Module Three Screening and Assessment V1.7.13.141031 Introduction to Modules Three and Four Modules Three and Four cover the key components of SBIRT screening, assessment and brief intervention. The screening,

More information

Overview. APPLIED PREVENTION & intervention STRATEGIES. APPLIED PREVENTION & intervention STRATEGIES

Overview. APPLIED PREVENTION & intervention STRATEGIES. APPLIED PREVENTION & intervention STRATEGIES Overview in the Context of a Comprehensive System of Care Overview of Evidence-Based Brief Motivational Interventions Screening and Referral Overview Session 1 Session 2 2 APPLIED PREVENTION & intervention

More information

A Comprehensive Model of Stepped Care for Substance Misuse Prevention on a College Campus

A Comprehensive Model of Stepped Care for Substance Misuse Prevention on a College Campus A Comprehensive Model of Stepped Care for Substance Misuse Prevention on a College Campus Steven W. Clarke, PhD Director of Health Promotion & Prevention Services Binghamton University Jennifer F. Wagstaff,

More information

Alcohol Misuse Clinical Pathway Outline

Alcohol Misuse Clinical Pathway Outline Alcohol Misuse Clinical Pathway Outline 1. Identification of Patients for Alcohol Misuse Pathway a. Criteria for inclusion into alcohol misuse clinical pathway: Patients meeting the following criteria

More information

Addiction. Concept of Addiction R. Corey Waller MD, MS, FACEP, FASAM Director, Center for Integrative Medicine

Addiction. Concept of Addiction R. Corey Waller MD, MS, FACEP, FASAM Director, Center for Integrative Medicine Addiction Concept of Addiction R. Corey Waller MD, MS, FACEP, FASAM Director, Center for Integrative Medicine Twitter: @rcwallermd Objectives Understand the Concept of Addiction Survival FOOD WATER DOPAMINE

More information

Chapter 7. Screening and Assessment

Chapter 7. Screening and Assessment Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions

More information

KAP Keys. For Clinicians. Based on TIP 24 A Guide to Substance Abuse Services for Primary Care Clinicians. CSAT s Knowledge Application Program

KAP Keys. For Clinicians. Based on TIP 24 A Guide to Substance Abuse Services for Primary Care Clinicians. CSAT s Knowledge Application Program KAP KEYS Based on TIP 24 A Guide to Substance Abuse Services for Primary Care CSAT s Knowledge Application Program KAP Keys For Based on TIP 24 A Guide to Substance Abuse Services for Primary Care U.S.

More information

Neurobiology of Drug Abuse and Addiction PSYC 450

Neurobiology of Drug Abuse and Addiction PSYC 450 Neurobiology of Drug Abuse and Addiction PSYC 450 Healthy Control Drug Abuser Illicit drug use, lifetime and past year, in Canada 50 Canabis only Any drug Any of 5 drugs (without canabis) (CADUMS 2012)

More information

SBIRT Screening and Brief Assessment Questionnaires

SBIRT Screening and Brief Assessment Questionnaires SBIRT Screening and Brief Assessment Questionnaires 1. Brief Screens: NIAAA quantity and frequency Single alcohol screening question) Single drug screening question Conjoint screening questions 2. Full

More information

Substance Use Disorders

Substance Use Disorders Substance Use Disorders Substance Use Disorder This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars monthly to address topics related to risk adjustment documentation and

More information

An Internist s Guide to Unhealthy Alcohol Use. Ryan Graddy, MD JHU SOM

An Internist s Guide to Unhealthy Alcohol Use. Ryan Graddy, MD JHU SOM An Internist s Guide to Unhealthy Alcohol Use Ryan Graddy, MD JHU SOM Disclosures None Learning Objectives Understand the terminology used to describe unhealthy alcohol use Identify means of screening

More information

Clinical and public health significance of the proposed changes to the diagnosis of alcohol abuse and dependence in DSM-5

Clinical and public health significance of the proposed changes to the diagnosis of alcohol abuse and dependence in DSM-5 Clinical and public health significance of the proposed changes to the diagnosis of alcohol abuse and dependence in DSM-5 Dr Tim Slade, Senior Research Fellow, National Drug and Alcohol Research Centre,

More information

Do I Have a Drinking Problem?

Do I Have a Drinking Problem? People drink for all sorts of reason. Some reasons are to socialize, celebrate and relax. Other times people use alcohol as a form of self-medication to help them manage stress, anxiety or to use it to

More information

Substance and Alcohol Related Disorders. Substance use Disorder Alcoholism Gambling Disorder

Substance and Alcohol Related Disorders. Substance use Disorder Alcoholism Gambling Disorder Substance and Alcohol Related Disorders Substance use Disorder Alcoholism Gambling Disorder What is a Substance Use Disorder? According to the DSM-5, a substance use disorder describes a problematic pattern

More information

Clinical Evaluation: Assessment Goals

Clinical Evaluation: Assessment Goals Clinical Evaluation: Assessment Goals 1. Define Assessment Process 2. Identify Assessment Instruments 3. Define DSM-5 criteria for Substance Abuse and Dependence, specifiers and multi-axial assessment

More information

The Council for Disability Awareness

The Council for Disability Awareness Alcohol and Your Health It's a fact: alcohol is a prevalent part of our social lives. We unwind by drinking a beer or two at the game or having a glass of wine with dinner. We toast holidays and special

More information

Shhh! Let s Talk About Moderation for Mild Alcohol Use Disorders. Cyndi Turner, LCSW, LSATP, MAC Craig James, LCSW, MAC

Shhh! Let s Talk About Moderation for Mild Alcohol Use Disorders. Cyndi Turner, LCSW, LSATP, MAC Craig James, LCSW, MAC Shhh! Let s Talk About Moderation for Mild Alcohol Use Disorders Cyndi Turner, LCSW, LSATP, MAC Craig James, LCSW, MAC Shhh! Let s Talk About Moderation for Mild to Moderate Alcohol Use Disorders Insight

More information

Substance Use Disorders: Diagnosis and Treatment in Primary Care

Substance Use Disorders: Diagnosis and Treatment in Primary Care Substance Use Disorders: Diagnosis and Treatment in Primary Care October 27, 2016 Agenda Opening Remarks Housekeeping Presentation Q&A Closing Remarks 2 Introduction to the atom Alliance Multi-state alliance

More information

Common Diagnosis Codes and Tips for Coding Nicotine Use/

Common Diagnosis Codes and Tips for Coding Nicotine Use/ ICD-10 Tobacco Billing Guide ICD-10 and Tobacco Common Diagnosis Codes and Tips for Coding Nicotine Use/ Dependence Tobacco use is the leading cause of preventable disease and death in the United States,

More information

Underwriting the Habits Risk of Alcohol Use Gregory Ferrara New York Life Underwriting January, 2013

Underwriting the Habits Risk of Alcohol Use Gregory Ferrara New York Life Underwriting January, 2013 Underwriting the Habits Risk of Alcohol Use Gregory Ferrara New York Life Underwriting January, 2013 The Company You Keep 1 Antitrust 2 New York Life adheres to the letter and spirit of the antitrust laws.

More information

Substance Misuse Nurse service Belfast Trust

Substance Misuse Nurse service Belfast Trust Substance Misuse Nurse service Belfast Trust Alcohol is the most widely available socially acceptable drug in Northern Ireland It can be an addictive substance It is a depressant- slows down the central

More information

DrinkCheck. Is your drinking okay?

DrinkCheck. Is your drinking okay? DrinkCheck Is your drinking okay? WHAT SORT OF DRINKER ARE YOU? Test your drinking... DrinkCheck can help you find out more about your drinking. Just complete the questionnaire and add up your score. Then

More information

Seek, Test, Treat and Retain for Criminal Justice Populations: Data Harmonization Measure

Seek, Test, Treat and Retain for Criminal Justice Populations: Data Harmonization Measure Seek, Test, Treat and Retain for Criminal Justice Populations: Measure Drug and Alcohol Use Drug and Alcohol Measure References: 1) Adapted from: Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B. & Monteiro,

More information

Pocket Card SBIRT Side 1 and 2

Pocket Card SBIRT Side 1 and 2 Pocket Card SBIRT Side 1 and 2 Pocket Card SBIRT Health Effects of Substance Abuse Alcohol Use Disorders Identification test (AUDIT) NAME: Date: The following questions concern information about your alcohol

More information

1/10/2017. A common Alcoholics Anonymous (AA) saying is There is no problem that alcohol cannot make worse.

1/10/2017. A common Alcoholics Anonymous (AA) saying is There is no problem that alcohol cannot make worse. Alcohol still addicts more people than all other drugs combined Understand difference between alcohol use, abuse and dependence Learn the potential physiological and emotional affects of alcohol Distinguish

More information

Lecture 19. Alcohol Use. Lecture 19

Lecture 19. Alcohol Use. Lecture 19 Lecture 19 Alcohol Use 1 Lecture 19 1. What is Alcohol? 2. History of Alcohol Consumption 3. Patterns of Alcohol Use 4. Short-Term Effects of Alcohol Use 5. Long-Term Effects of Alcohol Use 6. Alcohol

More information

Chapter 9 Lecture. Chapter 9: Alcohol Pearson Education, Inc.

Chapter 9 Lecture. Chapter 9: Alcohol Pearson Education, Inc. Chapter 9 Lecture Chapter 9: Alcohol Objectives for Chapter 9 Explain what alcohol is and how it is made. Explain why people drink alcohol. Describe how alcohol is absorbed and metabolized in the body.

More information

Opioid Use Issues: All the Players

Opioid Use Issues: All the Players Opioid Use Issues: All the Players Objectives After review, the participant will be able to: 1) Identify criteria for opioid use disorders Andrew J. McLean, MD, MPH Medical Director, ND Department of Human

More information

What You Don t Know Can Harm You

What You Don t Know Can Harm You A LCOHOL What You Don t Know Can Harm You U.S. Department of Health and Human Services National Institutes of Health National Institute on Alcohol Abuse and Alcoholism If you are like many Americans,

More information

Alcohol's Effects on the Body

Alcohol's Effects on the Body Alcohol's Effects on the Body Drinking too much on a single occasion or over time can take a serious toll on your health. Here s how alcohol can affect your body: Brain: Alcohol interferes with the brain

More information

DrinkCheck Is your drinking okay?

DrinkCheck Is your drinking okay? DrinkCheck Is your drinking okay? What so of drin are you DrinkCheck can help you about your drinking. Just questionnaire and add u Then find out what it mea *DrinkCheck is for people 18 years or older.

More information

Delivering an ABI: Process, screening tools and guidance notes. Alcohol brief interventions A&E professional pack

Delivering an ABI: Process, screening tools and guidance notes. Alcohol brief interventions A&E professional pack Delivering an ABI: Process, screening tools and guidance notes Alcohol brief interventions A&E professional pack We are happy to consider requests for other languages or formats. Please contact 0131 314

More information

Shatter the Stigma J e s s i c a C a n d e l a r i a L i p s e y, M S W R e g i s t e r e d C l i n i c a l S o c i a l W o r k I n t e r n

Shatter the Stigma J e s s i c a C a n d e l a r i a L i p s e y, M S W R e g i s t e r e d C l i n i c a l S o c i a l W o r k I n t e r n Shatter the Stigma J e s s i c a C a n d e l a r i a L i p s e y, M S W R e g i s t e r e d C l i n i c a l S o c i a l W o r k I n t e r n My Story Addiction, impacting more than 45 million Americans

More information

Wasted AN INTRODUCTION TO SUBSTANCE ABUSE

Wasted AN INTRODUCTION TO SUBSTANCE ABUSE Wasted AN INTRODUCTION TO SUBSTANCE ABUSE Dr. Brian L. Bethel Child and Family Therapist Independent Trainer and Consultant LPCC-S, LCDC III, RPT-S www.brianlbethel.com INTERPLAY COUNSELING & CONSULTING

More information

Acute General Medical and Surgical Admission:

Acute General Medical and Surgical Admission: Acute General Medical and Surgical Admission: Managing Substance Use Disorders in Patients Who are Severely Ill Scott Grantham, MD Executive Director, Behavioral Health Saint Francis Health System By the

More information

Opioid Analgesics: Responsible Prescribing in the Midst of an Epidemic

Opioid Analgesics: Responsible Prescribing in the Midst of an Epidemic Opioid Analgesics: Responsible Prescribing in the Midst of an Epidemic Lucas Buffaloe, MD Associate Professor of Clinical Family and Community Medicine University of Missouri Health Care Goals for today

More information

Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders. William L. Bograkos, MA, DO, FACOEP

Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders. William L. Bograkos, MA, DO, FACOEP Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders Toxic Brain Disorders William L. Bograkos, MA, DO, FACOEP TBI: Traumatic Brain Injury / Toxic Brain Injury (Trauma and Substance

More information

DrinkCheck. Is your drinking okay?

DrinkCheck. Is your drinking okay? DrinkCheck Is your drinking okay? WHAT SO OF DRIN ARE YOU DrinkCheck can help you about your drinking. Just questionnaire and add u Then find out what it me *DrinkCheck is for people 8 years or older.

More information

MEDICAL HISTORY FORM FOR FOLLOW-UP

MEDICAL HISTORY FORM FOR FOLLOW-UP MEDICAL HISTORY FORM FOR FOLLOW-UP ID NUMBER: 0a) Date of Collection / / 0b) Staff Code Instructions: Whenever numerical responses are required, enter the number so that the last digit appears in the rightmost

More information

What is a Trauma Center? What is a Trauma Center? Minnesota Trauma Centers. Alcohol Screening and Brief Intervention in the Trauma Center Setting

What is a Trauma Center? What is a Trauma Center? Minnesota Trauma Centers. Alcohol Screening and Brief Intervention in the Trauma Center Setting What is a Trauma Center? Alcohol Screening and Brief Intervention in the Trauma Center Setting Alison Pence, MPH North Memorial Medical Center Robbinsdale,, MN Trauma Center is a designation given by the

More information

Taking Control of Alcohol Use

Taking Control of Alcohol Use Taking Control of Alcohol Use Session 1: About Alcohol Use. This workbook accompanies the e-course Taking Control of Alcohol Use and is for the exclusive use of clients and customers of Homewood Human

More information

ALCOHOL USE DISORDER WITHDRAWAL MANAGEMENT AND LONG TERM TREATMENT ANA HOLTEY, MD ADDICTION MEDICINE FELLOW UNIVERSITY OF UTAH HEALTH

ALCOHOL USE DISORDER WITHDRAWAL MANAGEMENT AND LONG TERM TREATMENT ANA HOLTEY, MD ADDICTION MEDICINE FELLOW UNIVERSITY OF UTAH HEALTH ALCOHOL USE DISORDER WITHDRAWAL MANAGEMENT AND LONG TERM TREATMENT ANA HOLTEY, MD ADDICTION MEDICINE FELLOW UNIVERSITY OF UTAH HEALTH Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV

More information

HIV and alcohol use: why is risk reduction in alcohol use important in HIV care?

HIV and alcohol use: why is risk reduction in alcohol use important in HIV care? HIV and alcohol use: why is risk reduction in alcohol use important in HIV care? Susanne Astrab Fogger, DNP, PMHNP-BC, CARN-AP, FAANP sfogger@uab.edu Objectives for today s session Define alcohol use disorder

More information

Alcoholic beverages no ordinary food commodities

Alcoholic beverages no ordinary food commodities Alcoholic beverages no ordinary food commodities V. Poznyak, MD, PhD Coordinator, Management of Substance Abuse Department of Mental Health and Substance Abuse Codex Committee on Food Labelling 17 October

More information

Opiate Use Disorder and Opiate Overdose

Opiate Use Disorder and Opiate Overdose Opiate Use Disorder and Opiate Overdose Irene Ortiz, MD Medical Director Molina Healthcare of New Mexico and South Carolina Clinical Professor University of New Mexico School of Medicine Objectives DSM-5

More information

Screening and Addressing Alcohol Use In Primary Care

Screening and Addressing Alcohol Use In Primary Care Screening and Addressing Alcohol Use In Primary Care Mark R. Loush, LMSW, CAADC August 15, 20167 Objectives Identify the primary reasons why screening for alcohol in primary care is important Understand

More information

CANAM INTERVENTIONS. Addiction

CANAM INTERVENTIONS. Addiction CANAM INTERVENTIONS Addiction PREVENTION RESEARCH FACTS The principles listed below are the result of long-term research studies on the origins of drug abuse behaviors and the common elements of effective

More information

SUBSTANCE USE DISORDER IN ADOLESCENT POPULATION

SUBSTANCE USE DISORDER IN ADOLESCENT POPULATION Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences SUBSTANCE USE DISORDER IN ADOLESCENT POPULATION ANNABELLE SIMPSON, MD UNIVERSITY OF WASHINGTON GENERAL DISCLOSURES

More information

Managing the Member with Substance Use: (Alcohol) November 15, Presenter: Steve Edfors, LCPC

Managing the Member with Substance Use: (Alcohol) November 15, Presenter: Steve Edfors, LCPC Managing the Member with Substance Use: (Alcohol) November 15, 2018 Presenter: Steve Edfors, LCPC University of Illinois at Chicago College of Nursing 1 Learning Objectives Upon completion of this learning

More information

Survey of Temporary Assistance For Needy Families (TANF) Recipients

Survey of Temporary Assistance For Needy Families (TANF) Recipients State of Oklahoma State Treatment Needs Assessment Program Phase II CSAT Contract No. 270-98-7066 September 30, 2001 Survey of Temporary Assistance For Needy Families (TANF) Recipients EXECUTIVE SUMMARY

More information

Important Information

Important Information Important Information Please work through the following pages with your patient or the patient s chart as necessary. Fax completed documents to 1 888 629-4722. Keep the original in your chart / file. Fee:

More information

ADULT Addictions Treatment: Medically Monitored Residential Treatment (3B)

ADULT Addictions Treatment: Medically Monitored Residential Treatment (3B) ADULT Addictions Treatment: Medically Monitored Residential Treatment (3B) Program Medically Monitored Short Term Residential treatment provides 24 hour professionally directed evaluation, care, and treatment

More information

Welcome! Today we ll discuss some of the important relationships between physical health and substance use that clinicians may encounter as they apply

Welcome! Today we ll discuss some of the important relationships between physical health and substance use that clinicians may encounter as they apply Welcome! Today we ll discuss some of the important relationships between physical health and substance use that clinicians may encounter as they apply the SBIRT process in practice. 1 We ll start by considering

More information

Mental Disorders with Associated Harmful Behavior and Substance-Related Disorders

Mental Disorders with Associated Harmful Behavior and Substance-Related Disorders Mental Disorders with Associated Harmful Behavior and Substance-Related Disorders Kishore Desagani, MD General Adult and Forensic Psychiatrist Consultant Psychiatrist Medical Assessment and Policy Team

More information

Module 2.3. Brief interventions for harmful alcohol use at primary health care level

Module 2.3. Brief interventions for harmful alcohol use at primary health care level Module 2.3 Brief interventions for harmful alcohol use at primary health care level What s inside Introduction Learning outcomes Topics covered Competency Teaching and learning activities Background information

More information

Welcome to the second module of the Screening, Brief Intervention, and Referral to Treatment Core Curriculum. In this module, we ll address screening

Welcome to the second module of the Screening, Brief Intervention, and Referral to Treatment Core Curriculum. In this module, we ll address screening Welcome to the second module of the Screening, Brief Intervention, and Referral to Treatment Core Curriculum. In this module, we ll address screening patients for substance use in a clinical setting. 1

More information

The burden caused by alcohol

The burden caused by alcohol The burden caused by alcohol Presentation at REDUCING THE HARM CAUSED BY ALCOHOL: A COORDINATED EUROPEAN RESPONSE Tuesday, November 13 Jürgen Rehm Centre for Addiction and Mental Health, Toronto, Canada

More information

Chapter 13. Types of Drugs and Their Effects. Unit 5: Drug Use and Abuse. Key Terms. What Are Drugs?

Chapter 13. Types of Drugs and Their Effects. Unit 5: Drug Use and Abuse. Key Terms. What Are Drugs? : Chapter 13 Types of Drugs and Their Effects Key Terms drugs psychoactive drugs marijuana (cannabis) hallucinogens depressants stimulants anabolic steroids continuum of drug use bingeing physical dependence

More information

Lesson 1 (pg )

Lesson 1 (pg ) Lesson 1 (pg 348-351) Definitions Alcohol- a drug created by a chemical reaction in some foods, especially fruits and grains Drug- a substance other than food that changes the structure or function of

More information

NTNC Membership Opportunities NTNC MEMBERSHIP DRIVE WEBINAR. Juggling TB and Alcoholism. Nurse Case Management of the TB Patient April 14, 2016

NTNC Membership Opportunities NTNC MEMBERSHIP DRIVE WEBINAR. Juggling TB and Alcoholism. Nurse Case Management of the TB Patient April 14, 2016 NTNC MEMBERSHIP DRIVE WEBINAR It s Never Just TB Juggling TB and Alcoholism Nurse Case Management of the TB Patient April 14, 2016 National Tuberculosis Nurse Coalition The mission of the NTNC is to advise

More information

First the Man Takes a Drink... Texas Lawyers Assistance Program September, 2014 Marilyn J Vaché MD, Medical Director, Austin Recovery

First the Man Takes a Drink... Texas Lawyers Assistance Program September, 2014 Marilyn J Vaché MD, Medical Director, Austin Recovery First the Man Takes a Drink... Texas Lawyers Assistance Program September, 2014 Marilyn J Vaché MD, Medical Director, Austin Recovery Everyone who drinks alcohol is at risk of losing control of drinking,

More information

The more you drink, the greater your risk of alcohol-related harm.

The more you drink, the greater your risk of alcohol-related harm. Women and alcohol Women and alcohol In Ireland, most of the messages we get about alcohol emphasise the positive side relaxing and having fun with friends. We don t talk often about the negatives, but

More information

Appendix F Federation of State Medical Boards

Appendix F Federation of State Medical Boards Appendix F Federation of State Medical Boards Model Policy Guidelines for Opioid Addiction Treatment in the Medical Office SECTION I: PREAMBLE The (name of board) recognizes that the prevalence of addiction

More information

Harmful Use of Alcohol A Global Public Health Perspective

Harmful Use of Alcohol A Global Public Health Perspective GLOBAL ALCOHOL POLICY CONFERENCE COEX Congress Centre, Seoul, Republic of Korea, 7 October 2013 Harmful Use of Alcohol A Global Public Health Perspective Mr Dag Rekve Department of Mental Health and Substance

More information

Alcohol advice and local support

Alcohol advice and local support Alcohol advice and local support This information leaflet has been given to you by your doctor or nurse to provide further information and advice about alcohol and where you can get local support. How

More information

Chester County Drug & Alcohol Services Map

Chester County Drug & Alcohol Services Map START Call 911 Chester County Drug & Alcohol Services Map Are you in a lifethreatening situation/ condition (medical or psychiatric)? Do you need ambulance assistance? Go to the nearest hospital/er You

More information

Alcohol-Related Liver Disease

Alcohol-Related Liver Disease Alcohol-Related Liver Disease Nonalcoholic Fatty Liver Disease (NAFLD) 1 Why is the liver important? Your liver is a vital organ that performs many essential functions. It filters out harmful substances

More information

Using Health IT to Support Oral Health Integration: Dealing with Common Barriers. Jeff Hummel, MD, MPH Qualis Health November 5, 2015

Using Health IT to Support Oral Health Integration: Dealing with Common Barriers. Jeff Hummel, MD, MPH Qualis Health November 5, 2015 Using Health IT to Support Oral Health Integration: Dealing with Common Barriers Jeff Hummel, MD, MPH Qualis Health November 5, 2015 Goals for this Session Understand 3 aspects of oral health information

More information

March 29, 2017 Debra K. Smith, Ph.D. St. Charles Hospital Port Jefferson, New York

March 29, 2017 Debra K. Smith, Ph.D. St. Charles Hospital Port Jefferson, New York Traumatic Brain Injury: Management of Psychological and Behavioral Sequelae March 29, 2017 Debra K. Smith, Ph.D. St. Charles Hospital Port Jefferson, New York The Functional Impact of

More information

At the conclusion of this presentation, you will be able to: Discuss reasons to screen for alcohol use.

At the conclusion of this presentation, you will be able to: Discuss reasons to screen for alcohol use. A New Comprehensive Alcohol Screening Tool to Guide Primary Care Practice Jon Glover, LCSW Behavioral Health Project Specialist MetaStar Objectives At the conclusion of this presentation, you will be able

More information

History of Present Illness (HPI) Assessment and Plan Template

History of Present Illness (HPI) Assessment and Plan Template History of Present Illness (HPI) Assessment and Plan Template Templates for induction and follow-up appointments for medication assisted treatment (MAT) in opioid use disorder (OUD). Consider saving this

More information

Template Control Page. Substance Misuse Newham Template Guide. Substance Misuse Newham. Date September 2015 DOCUMENT MANAGEMENT REVISION HISTORY

Template Control Page. Substance Misuse Newham Template Guide. Substance Misuse Newham. Date September 2015 DOCUMENT MANAGEMENT REVISION HISTORY Template Control Page Substance Misuse Newham Template Guide Title Substance Misuse Newham Author CEG Status Active Date September 2015 DOCUMENT MANAGEMENT REVISION HISTORY Version Date Summary of Changes

More information

Screening and Intervention Among Undergraduates with Alcohol-Related Emergency Department Visits

Screening and Intervention Among Undergraduates with Alcohol-Related Emergency Department Visits Screening and Intervention Among Undergraduates with Alcohol-Related Emergency Department Visits Erik Gunderson, MD Assistant Professor Department of Psychiatry and Neurobehavioral Sciences, Department

More information

The alcohol treatment needs of violent and non-violent prisoners

The alcohol treatment needs of violent and non-violent prisoners Practice The alcohol treatment needs of violent and non-violent prisoners N Bowes A Sutton S Jenkins FORENSIC PSYCHOLOGICAL SERVICES, NOMS CYMRU, HMP CARDIFF J McMurran INSTITUTE OF MENTAL HEALTH, UNIVERSITY

More information

Directed Reading. Lesson: Understanding Teens and Alcohol WHY TEENS DRINK. Lesson: Alcohol and Your Body ALCOHOL IN YOUR BODY

Directed Reading. Lesson: Understanding Teens and Alcohol WHY TEENS DRINK. Lesson: Alcohol and Your Body ALCOHOL IN YOUR BODY Skills Worksheet Directed Reading Lesson: Understanding Teens and Alcohol WHY TEENS DRINK 1 Beer and wine on television and in grocery stores encourage alcohol purchases 2 A normal response to seeing older

More information

BAPTIST HEALTH SCHOOL OF NURSING NSG 3036A: PSYCHIATRIC-MENTAL HEALTH

BAPTIST HEALTH SCHOOL OF NURSING NSG 3036A: PSYCHIATRIC-MENTAL HEALTH BAPTIST HEALTH SCHOOL OF NURSING NSG 3036A: PSYCHIATRIC-MENTAL HEALTH THERAPEUTIC INTERVENTION AND RESOURCE MANAGEMENT: SUBSTANCE RELATED DISORDERS: CO-DEPENDENCY AND THE IMPAIRED NURSE LECTURE OBJECTIVES:

More information

FOUR SELF-TESTS: SEXUAL ADDICTION, SEXUAL ANOREXIA, BINGE-PURGE, COLLATERAL INDICATORS

FOUR SELF-TESTS: SEXUAL ADDICTION, SEXUAL ANOREXIA, BINGE-PURGE, COLLATERAL INDICATORS FOUR SELF-TESTS: SEXUAL ADDICTION, SEXUAL ANOREXIA, BINGE-PURGE, COLLATERAL INDICATORS 1. SEXUAL ADDICTION CRITERIA Each of the sexual addiction criteria is listed below. Record whether you think your

More information

Self Provision of Alcohol and Drugs Ottawa s Managed Alcohol Program: A Fundamental Component of an Overarching Strategy for the Care of the Homeless

Self Provision of Alcohol and Drugs Ottawa s Managed Alcohol Program: A Fundamental Component of an Overarching Strategy for the Care of the Homeless Self Provision of Alcohol and Drugs Ottawa s Managed Alcohol Program: A Fundamental Component of an Overarching Strategy for the Care of the Homeless April 24, 2013 Dr. Jeffrey Turnbull Founder & Medical

More information

Alcohol and Cancer: Defining the Exposure and Key Milestones in Establishing the Relationship

Alcohol and Cancer: Defining the Exposure and Key Milestones in Establishing the Relationship Alcohol and Cancer: Defining the Exposure and Key Milestones in Establishing the Relationship Susan M. Gapstur, PhD, MPH Vice President, Epidemiology American Cancer Society 1 Disclosure Information SUSAN

More information

Welcome! Today we ll discuss some of the important relationships between mental and physical health that clinicians may encounter as they apply the

Welcome! Today we ll discuss some of the important relationships between mental and physical health that clinicians may encounter as they apply the Welcome! Today we ll discuss some of the important relationships between mental and physical health that clinicians may encounter as they apply the SBIRT process in practice. 1 We ll start by considering

More information

Prepared by: Dr. Elizabeth Woodward, University of Toronto Resident in Psychiatry

Prepared by: Dr. Elizabeth Woodward, University of Toronto Resident in Psychiatry Prepared by: Dr. Elizabeth Woodward, University of Toronto Resident in Psychiatry In broad terms, substance use disorders occur when a substance is used in a compulsive manner with a lack of control over

More information

THE ADDICTIVE BRAIN SC 212 JANUARY 3, 2017 JOHN BUSH

THE ADDICTIVE BRAIN SC 212 JANUARY 3, 2017 JOHN BUSH THE ADDICTIVE BRAIN SC 212 JANUARY 3, 2017 JOHN BUSH ADDICTS ADDICTIONS? WHAT CAUSES ADDICTIONS? Addiction is the result of substance abuse by people with moral failings or personality defects. Addiction

More information

NORTHWEST AIDS EDUCATION AND TRAINING CENTER. Opioid Use Disorders. Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014

NORTHWEST AIDS EDUCATION AND TRAINING CENTER. Opioid Use Disorders. Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014 NORTHWEST AIDS EDUCATION AND TRAINING CENTER Opioid Use Disorders Joseph Merrill M.D., M.P.H. University of Washington April 10, 2014 Opioid Use Disorders Importance of opioid use disorders Screening and

More information

Patterns of Alcohol Use

Patterns of Alcohol Use Alcohol and Tobacco Learning Objectives 1) Describe the patterns of alcohol use, and the health risks and social problems that can result from alcohol use, abuse, and dependence 2) Explain treatment approaches

More information

IntNSA 2017 Annual Educational Conference. SBIRT: the role of nurses in universal screening for substance use

IntNSA 2017 Annual Educational Conference. SBIRT: the role of nurses in universal screening for substance use IntNSA 2017 Annual Educational Conference SBIRT: the role of nurses in universal screening for substance use SBIRT overview screening practices agenda brief intervention strategies additional resources

More information

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) دکتر راد گودرزی

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) دکتر راد گودرزی The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) 1 Expanded to include Gambling Disorder Cannabis Withdrawal and Caffeine Withdrawal are new disorders Caffeine Withdrawal

More information

Assignment 3. Alcohol Pearson Education, Inc.

Assignment 3. Alcohol Pearson Education, Inc. Assignment 3 Alcohol In Depth: Alcohol Alcohols are chemical compounds characterized by a hydroxyl group In common usage, beverages containing ethanol made from fermented fruits, vegetables, or grains

More information

Conway PMS. NHS Health Check Questionnaire

Conway PMS. NHS Health Check Questionnaire Conway PMS NHS Health Check Questionnaire We would be grateful if you could kindly complete this survey. Please be as honest as possible to help us to help you. Name: Male Female D of B: dd / mm / yyyy

More information

LifeBridge Physician Network Care Path Depression, Substance Abuse June 26, 2015

LifeBridge Physician Network Care Path Depression, Substance Abuse June 26, 2015 LifeBridge Physician Network Care Path Depression, Substance Abuse June 26, 2015 LBPN Care Path Aim: To develop and implement standard protocols, based on the best evidence, that provide a consistent clinical

More information

Alcohol Use-Good or Bad for You? Going for the 3 Increases: Increase in Health, Increase in Happiness & Increase in Energy

Alcohol Use-Good or Bad for You? Going for the 3 Increases: Increase in Health, Increase in Happiness & Increase in Energy Alcohol Use-Good or Bad for You? Going for the 3 Increases: Increase in Health, Increase in Happiness & Increase in Energy Strategies for Success in Health Management By: James J. Messina, Ph.D. How Big

More information

Alcohol and cancer. Peter Anderson MD, MPH, PhD

Alcohol and cancer. Peter Anderson MD, MPH, PhD Alcohol and cancer Peter Anderson MD, MPH, PhD Professor, Substance Use, Policy and Practice, Institute of Health and Society, Newcastle University, England Professor, Alcohol and Health, Faculty of Health,

More information

ALCOHOL AND YOU Alcohol

ALCOHOL AND YOU Alcohol ALCOHOL AND YOU Alcohol BEYOND ALCOHOL, WITHIN YOURSELF As you transition to college, one of the decisions that you and your classmates face deals with alcohol. While most of you faced decisions about

More information

Name: Gender: male female Age: Date of birth: / / Preferred phone: cell home work other. Alternate phone: cell home work other.

Name: Gender: male female Age: Date of birth: / / Preferred phone: cell home work other. Alternate phone: cell home work other. Casey Alexander Paleos, MD NEW CLIENT INTAKE FORM 775 Park Avenue, Suite 200-2 Huntington, NY 11743 tel 631-629-5887 Date: / / BASIC INFORMATION Name: Gender: male female Age: Date of birth: / / Preferred

More information

ALCOHOLISM GETTING THE FACTS FACT SHEET 06. Visit: alcoholandyouni.com

ALCOHOLISM GETTING THE FACTS FACT SHEET 06. Visit: alcoholandyouni.com FACT SHEET 06 ALCOHOLISM GETTING THE FACTS Most of us think we know something about alcoholism and drug addiction. After all, there are stories about addiction on TV and in the newspapers almost every

More information

Alcohol and Other Drug Screening & Assessment

Alcohol and Other Drug Screening & Assessment Alcohol and Other Drug Screening & Assessment Richard Saitz, MD, MPH, FACP, FASAM Professor of Medicine & Epidemiology Boston University Schools of Medicine & Public Health Boston Medical Center Do substance

More information

Critiquing the Construction of Addiction: Dependence, Disorder and the DSM V

Critiquing the Construction of Addiction: Dependence, Disorder and the DSM V Critiquing the Construction of Addiction: Dependence, Disorder and the DSM V Helen Keane School of Sociology Australian National University Addiction A hybrid moral medical category defined by pathological

More information

STEPS TO DEVELOPING A COMPREHENSIVE DUAL DISORDERS PROGRAM IN A MENTAL HEALTH SETTING

STEPS TO DEVELOPING A COMPREHENSIVE DUAL DISORDERS PROGRAM IN A MENTAL HEALTH SETTING 7 STEPS TO DEVELOPING A COMPREHENSIVE DUAL DISORDERS PROGRAM IN A MENTAL HEALTH SETTING By Mark Sanders, LCSW, CADC Studies indicate that 50% of the chronically mentally ill have concurrent substance abuse

More information

Initial Report of Oregon s State Epidemiological Outcomes Workgroup. Prepared by:

Initial Report of Oregon s State Epidemiological Outcomes Workgroup. Prepared by: Alcohol Consumption and Consequences in Oregon Prepared by: Addictions & Mental Health Division 5 Summer Street NE Salem, OR 9731-1118 To the reader, This report is one of three epidemiological profiles

More information

Healthy Living Self-Management Guide

Healthy Living Self-Management Guide Healthy Living Self-Management Guide Contents Eating Right... 3 Get Physical... 5 Weight Management... 7 Stress Management... 8 Mental Wellness... 9 Blood Pressure...10 Quit Smoking...11 Alcohol Use...

More information