Early-Stage Alcoholism

Assessment guidelines promulgated by the National Institute on Alcohol Ab wasting disease and intoxication (NIAAA, 1995) are reduced to two major recommendations: Ask close to typical drinking patterns, and ask ab come out personal and family history. A variety of psychometric instruments can be marshaled into identifying the specifics of a case. What is primary(prenominal) is to obtain information about the patient's physical condition by asking "about physical symptoms of substance abuse," including but non limited to GI occupations, as well as mien (Fox, 1998).

One of the most popular and widely cited in the literary works is the so-called cage in questionnaire (based on Mayfield, et al., 1974). The CAGE instrument makes use of four questions with key words in the questions spelling out cage. The questions are keyed as follows:

select you ever mat up you ought to cut down on your drinking?

Have hatful annoyed you by criticizing your drinking?

Have you ever matte up bad or guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or pick up unloosen of a hangover (eye-opener)? (NIAAA, 2001a).

The key to the effectiveness of CAGE as an assessment tool is said to be its nonconfrontationalism (NIAAA, 2001a). The importance of resonance with alcoholic patients is a point driven home repeatedly in the literature, and it must begin at the ear

NIAAA (1995) provides specific recommendations for follow-through in managing a case. Physicians are advised to ask for periodic updates from treatment specialists; to monitor symptoms of low and anxiety that may accompany abstinence; and to monitor abidance by testing for elevations in serum gamma-glutamyltransferase (GGT), which indicates excessive drinking. This would be consistent with both inpatient and outpatient treatment protocols.

Do you get physically sick (e.g., vomit, stomach cramps)as a result of drinking?

liest stage of clinical contact. The simplicity of CAGE is another benefit, and the condition of the questionnaire says that it predicts that patients who answer yes to two questions are in early-stage alcoholism, with yes answers to more(prenominal) indicating more severe cases.

This assertion appears to have been confirmed by non-homogeneous studies. However, at least one study indicates that, on its own, CAGE is less sensitive to early problem drinking (Hays & Spickard, 1987), of which plan of attack of increased nausea is an aspect.

According to the Addiction Resource hunt down (2002), determining whether to make an outpatient referral depends on two factors: willingness and ability to expect sessions regularly and abstinence for 48 hours at a time, with support. Patients who do not fit with those factors are candidates for inpatient treatment (rehab). What the ARG calls freestanding inpatient rehabilitation (e.g., Betty Ford Clinic) would be out of the pecuniary reach of most inpatients. However, many hospitals have rehab and/or detoxicateify units, both of which are typically covered by insurance. Rehab is alike routinely associated with 12-step treatment modalities. ARG cautions that in hospitals that have only detox units, follow-up rehabilitation is usually indicated. This is a potential problem in the instant case because of the possibility that detoxification could eliminate the alcoholic's GI comorbidity and demotivate him to continue with treatment (ARG, 2002)
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