Alcohol and alcoholism : international journal of the Medical Council on Alcoholism
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To assess recent drug use through urine testing as well as the prevalence of tobacco and alcohol dependence among young males and to analyse the associations between tobacco dependence and cannabis use (delta-9-tetrahydrocannabinol, THC), tobacco dependence, and alcohol dependence as well as between THC use and other illicit drug use. ⋯ Nicotine and alcohol dependence is common among young males. Biological assessment of illicit drug use seems to confirm previous questionnaire-based findings of associations between THC use and other illicit drugs. Urine testing seems to be an adequate method to analyse associations of THC use and other illicit drugs. In combination with questionnaires urine testing may be used for the assessment of associations of tobacco dependence and recent illicit drug use based on epidemiological surveys.
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To review the process of identifying alcohol-dependent patients at risk of developing Wernicke's encephalopathy (WE) in the community, and prophylactic treatment options. ⋯ Alcohol-dependent patients in the community who are at risk of developing WE should be given thiamine 250 mg, intramuscularly, daily for 3-5 days as part of a community detoxification programme. Further work is essential to determine the optimum dose of thiamine required to prevent permanent brain damage (Korsakoff's Psychosis). Neurotoxicity, due to the metabolism of excessive alcohol in patients with chronic and severe alcohol dependence, must be considered as an important factor in determining the long-term outcome of treatment.
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Comparative Study
Self-reported alcohol use among Dutch emergency room patients: variations in prevalence rates owing to methodological differences.
This study compared different methods of assessing self-reported alcohol use among emergency room patients in order to explain the variations in reported prevalence rates. ⋯ Future studies using patient self-report among emergency room samples should consider carefully the influence of sample selection bias. The combination of the research staff handing out the questionnaire and the emergency room staff giving their judgement on the patient's alcohol use seems to be a useful method.
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Alcohol consumption is often under-reported in patients admitted to general hospitals with acute illness. For alcohol-dependent individuals hospital admission results in an enforced period of abstinence with potential alcohol withdrawal symptoms, and possible life threatening complications. Early detection of alcohol use is therefore beneficial to patients and health services. The purpose of this study was to investigate the performance of the alcohol use disorders identification test (AUDIT) questionnaire in the acute medical setting, and the effect of combining routine biological markers-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, and mean corpuscular volume (MCV) on its performance in the early identification of in-patients with alcohol use disorders and at risk of developing symptoms of alcohol withdrawal. ⋯ These findings confirm that AUDIT is a useful alcohol screen in general medical settings and that its ability to correctly predict which patients will experience alcohol withdrawal is increased when used in combination with biological markers.