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History q? TRAP
- - types (beer, spirit, wine)
- - route of admission
- - amount
- - pattern of use (describe a regular day, night/day)
- - primary / prioritise
- - compulsion / craving
- - withdrawal
- - use despite ill harm
- (physical health, mental health, relationship, work, finances, forensic)
- (physical: head injury, blackout, fit, liver prob, heart prob)
- (mental: depression, anxiety, exacerbation of other mental health)
- Have you ever felt you should Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt bad or Guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?
Complications of alcohol abus
- 1. Wernicke's encephalopathy:
- thiamin deficiency leading to mammillary body damage
- - Ataxia
- - Nystagmus
- - Opthalmoplegia
- - Acute confusional state
- 2. Korsakoff's psychosis:
- from untreated long term Wernick's
- - Anterograde amnesia
- - Confabulation
- (unconscious filling in of gaps in memory by telling imaginary experiences)