Alcohol Abuse and Dependence

Gennine M. Zinner, RNCS, ANP Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Any pattern of alcohol use causing significant physical, mental, or social dysfunction; key features are tolerance, withdrawal, and persistent use despite problems.

  • Alcohol abuse: mal...

DIAGNOSIS

HISTORY

  • Behavioral issues

    • ▪ Anxiety, depression, insomnia
    • ▪ Psychological and social dysfunction, marital problems
    • ▪ Social isolation/withdrawal
    • ▪ Domestic violence
    • ▪ Alcohol-related legal problem...

TREATMENT

  • For management of acute withdrawal, please see “Alcohol Withdrawal.”

  • For outpatient withdrawal treatment, see “Alcohol Withdrawal, Treatment” or http://www.aafp.org/afp/2005/0201/p495.html.

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Outpatient detoxification: daily visits (not recommended for heavy alcohol abuse)

  • Early outpatient rehabilitation: weekly visits

  • Detoxification al...

REFERENCES

Dhalla  S, Kopec  JA. The CAGE Questionnaire for alcohol misuse: a review of reliability and validity studies. Clin Invest Med.  2007;30(1):33–41. [View Abstract on OvidInsights]
Smit...

ADDITIONAL READING

National Institute on Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician's guide. http://www.niaaa.nih.gov/guide. Accessed September 19, 2016.  

SEE ALSO

Substance Use Disorders; Alcohol Withdrawal 

CODES

ICD10

  • F10.10 Alcohol abuse, uncomplicated

  • F10.20 Alcohol dependence, uncomplicated

  • F10.239 Alcohol dependence with withdrawal, unspecified

  • F10.288Alcohol dependence with other alcohol-induced disord...

CLINICAL PEARLS

  • CAGE Questionnaire: >2 “yes” answers is 74-89% sensitive, 79-95% specific for alcohol use disorder; less sensitive for white women, college students, elderly. Not an appropriate too...

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