test my knowledge of alcohol misuse.

[SWM]

this morning i have applied for three jobs in a newly developed alcohol intervention team.

it has been almost 12 months since worked with alcohol misuse and if i am selected for interview i will be required to prove myself.  i am almost doubting my own ability already but i am prepared to do the work.

okay! ask me questions! test me, ask me anything about alcohol, alcohol misuse, hazardous and harmful drinking and alcohol dependence. anything you ever wondered, anything you ever wanted to know about harmful drinking, anything about alcohol.

[corwin137]

How do you diagnose and/or define alcoholism or addiction?

[SWM]

How do you diagnose and/or define alcoholism or addiction?

thats a good place to start.

firstly to clarify the differences in how alcoholism and a diagnosis of alcoholism is viewed.

in my experience the United Kingdom and the United states have very different ideas about alcoholism. the US defines alcoholism as a disease. the AA also adopt this position of alcohol as a disease. in the UK this is not the case, alcoholism is a behavioural problem that has resulted in biological and neurological adaptations.

alcoholism takes a variety of forms in relation to the quantity and type of drinking and the level of biological neurological adaptation to the alcohol. there are no clear medical definitions that i know of and so i rely on my own experience and understanding to guide and inform my definitions.

i'll start with the most severe end of the spectrum of alcohol dependence, which is a biological dependency on alcohol.

biological dependency is a result of neurological adaptations that take place when alcohol is present in the blood stream on a constant basis over a period of time. the changes in neuro-chemical balance takes place which counteracts the presence of alcohol. when a person stops drinking, at this level of alcoholism, the neuro-chemistry is so unbalanced that the individual will begin to experience strong adverse effects. the syptoms that are experience are known as alcohol withdrawal syndrome. due to alcohols sedative effect, which causes a person to feel realxed, the chemicals that are produced to counteract these in the brain are the same chemicals that we feel when we are anxious and restless. the presence of these chemical together with the alcohol are creating an artificial chemical balance. once the alcohol is metabolised and leaeves the system, the individual is left to feel the full force of these other chemicals which send the central nervous system in to hyper active state.

the  extreme end of alcohol withdrawal can cause symptoms such as palpatations, convulsions and seizures, hallucination and delusions and even heart failure.

if an individual has come to this level of alcoholism they are conisdered to be a dependent drinker. they will need to be treated for their alcoholism my a medical team. an individual at this level will need an assisted withdrawal treatment program, known commonly as a detox.


....

i have not had the time to research all the names of the chemicals involved , but this is how i  call it from my own knowledge....
i'll come back finish answering this question later on.

[corwin137]

Nice answers Stan.  Would also encourage consideration of DSM and/or ICD perspectives.  Fingers crossed for the gig...

[SWM]

your right, it is worth looking at those references. thanks. i have been too busy these last couple of days to answer the question properly. i will finish that question. if any body else wants to ask anything about alcohol and test my knowledge please do.

[corwin137]

My fave definition of addiction:

"A pathological relationship to any mood-altering experience that has life damaging consequences."

All the other definitions I know have problems- DSMs, ICDs, 12-step programs (all 137 definitions there  ).  This one has the fewest holes, I think.

[SWM]

returning to the first question and finishing this off..

the  extreme end of alcohol withdrawal can cause symptoms such as palpatations, convulsions and seizures, hallucination and delusions and even heart failure.

if an individual has come to this level of alcoholism they are conisdered to be a dependent drinker. they will need to be treated for their alcoholism by a medical team. an individual at this level will need an assisted withdrawal treatment program, known commonly as a detox.

if the person concerned is displaying evidence of withdrawal as descrbed above then he would be considered a dependent drinker and this is what i would myself define as alcoholism.

an addiction to aclohol can also be present without a biological dependence. there can be a biologically supported addiction. ie. the body is coming close to the biologcial dependence desscribed above but is not yet physically dependent. when alcohl is metabolised and is not present in the body there is a variety of discomfoting feelings and emotions which prompt the individual to continue drinking. if iat this stage the drinker resists drinking after a period of time this discomfort and the urges to drink will become less and eventually stop. if however the drinker continues to give into the urge to drink and uses alcohol to take away the feelings of anxiety and discomfort, then eventually a physical dependence (as described above) will occur.


 
a person who binge drinks will go through a cycle of not drinking and then drinking themself into oblivion. when they are on the drinking cycle they willy follow the patterns of the addicted and dependent drinker described above. drinking to reach states of euphoria or numbness or to elleviate uncomfortable feelings of depression or anxiety. for the binge drinker this drinking will continue and escelate unitl they bottom out and make themselves ill or unconscious and unable to function.

the binge drinker may experience mild to moderate withdrawal sypmptoms but will not show the extreme signs of withdrawal as seen in the dependent drinker.  however if the binge drinker has been a dependent drinker in the past, they are likely to have the same level of symptoms as they had when they where physcially dependent. in fact, i have not known many cases where a dependent drinker has been able to binge and stop, from my experience they will ususally return to full dependent drinking behavior.

there are other patterns of drinking that i would consider hazourdous and harmful and which border on addiction but i would definitely not describe as alcoholism. ie. a couple who drink a bottle or two of wine almost every night. a man who drinks three or four pints after work. i would consider this to be a habitual drinking pattern, with the possiblity of forming addiction.


ok, i had enough of that question now, i bored myself with that.

[SWM]

well i got the first interview next wednesday.

there are six vacancies in three positions so i expect another two interviews to follow.

lots of revision to do as i have not been working in this field for just on twelve months.

if any body has any thoughts on potential alcohol practitioner interview questions they will be GREATLY appreciated.

[SWM]

when i got home from work tonight i have got the dates for the other two interviews. three interviews in the next two weeks.

[corwin137]

Fingers crossed for you Stan. 

[SWM]

well, i never got the gig. i never got any of them. i geuss the universe wants me where i am for now.

[napster52]

Drug and alcohol misuse can lead to sickness, accidents, lateness, absenteeism, depression, reduced work rate, poor performance, safety concerns, bad behavior and poor discipline. Drug and alcohol misuse can have a negative effect on team morale and employee relationships.

==============================================================================

napster

[Shell]

Stan, real sorry you didn't make it sweetie.  If you don't mind me asking, what were the reasons?

[SWM]

thats okay, i really was not sure if wanted the job. well, actually i did want the job but i did not want to leave my current job.

i did'nt call the interview panel to get feedback about my interview. my first interview was really bad. i really did not understand many of the questions i was asked. the second interview they interviewed me for two roles at the same time. i was a bit more prepared for the style of questioning and i gave my best but i struggled on a couple of scenario questions. one scenario that i particularly messed up was about child protection and domestic violence. i could not remember the correct procedures around confidentiality when dealing with domestic violence around children. once that process had escaped my memory i found myself bumbling and rambling. i think that question was the nail in the coffin.

[sharoosunidhi]

Hi,
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=======================
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(Link removed by admin)

[Shell]

i did'nt call the interview panel to get feedback about my interview. my first interview was really bad. i really did not understand many of the questions i was asked. the second interview they interviewed me for two roles at the same time. i was a bit more prepared for the style of questioning and i gave my best but i struggled on a couple of scenario questions. one scenario that i particularly messed up was about child protection and domestic violence. i could not remember the correct procedures around confidentiality when dealing with domestic violence around children. once that process had escaped my memory i found myself bumbling and rambling. i think that question was the nail in the coffin.

Why do I keep missing this!  Ugh. 

Stan, I got nervous for you just reading your experience!!  I remember one of my most embarrassing moments, and I usually forget embarrassing moments, was going up for an awards board for my squadron.  OMG.  I didn't understand the questions either and because of that I just got completely ditzy.  Forgot my military bearing, turned bright red, even giggled a bit out of nervousness (on boards, you aren't supposed to show any emotion like that).  Holy crap I just wanted to die right there.  Just self combust.  I still cringe thinking about it.  When I was done, I was fuming at myself.  Didn't want to look the board members at all!!

[Enigma]

I like the UK definition of alcoholism a lot better than the US one. 

[saved]

I enjoy a drink or 2 almost every night and on saturday nights usualy more.  According to certain guidelines, I propbably have a problem, but realistically, I doubt it.  What is the criteria for being an alcoholic?  I use to be under the notion a physical addiction.

[anaklio]

@saved: Chemical addiction and mental illness are often linked (Wohl and Ades, 2009).  These authors note a co-occurrence rate of 25%-50%. I don't know if that is true for you, but it might be easier to manage alcohol use in the absence of mental illness.

[Bill Hemphill]

Saved, you said the following:

I enjoy a drink or 2 almost every night and on saturday nights usualy more.  According to certain guidelines, I propbably have a problem, but realistically, I doubt it.  What is the criteria for being an alcoholic?  I use to be under the notion a physical addiction.

_________________________

I have long believed that a person is not an alcoholic unless they are drinking way too much. Let me better define that. It's when a person has more energy attached to a sociological component than is good for them. A person can enjoy a fine cigar or a night of beverages. But when it it takes away energy from other pursuits or interests in their life, then they  definitely have a problem. I believe one is an alcoholic once they begin to tell themselves to "don't drink". That's when the addiction actually begins.

Bill


Stan, keep in mind that 99% of patients are not treated successfully. If you don't do things their way you may understand something that they don't. Trying to lighten things . . . good luck in your pursuits.

[SWM]

thanks for the kind words. i never got the gig for the alcohol services. although a better opportunity came along for me right after that which has allowed me to stay within mental health services.

their are different views of what alcoholism is in various parts of the world.
my personal definition of alcholism is that alchololism is the chemical dependency on alcohol.

after a prolonoged and continuous exposure to alcohol the chemical structure of the brain adapts to process the alcohol as a normal consituent of its chemical structure. this is the point at which the drinker becomes an alcoholic and about the same time that the drinker no longer gets drunk from consuming alcohol.

from this point the drinker is dependent on alcohol. if their body is deprived of alchol the impact on the chemical structure of the brain will cause them to experience withdrawal.

as regards treatment, the treatment is very easy to adminster and veryt succesful the problem is in the relapse rates after treatment. many services are now starting to adapt treatment to provide after care services for post detox treatment. but there is still much work to do to make these more effective.