Prevalent Pool Of Drinkers

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Prevalent Pool Of Drinkers

  1. 1. Loss - death Non-drinkers Low-risk drinkers Alcohol Use Disorder Incident cases of alcohol use disorder. Recovery Relapse Reward pathways Life events Support networks Family history Intervention Intervention cues <ul><li>Alcohol Use Disorders: </li></ul><ul><li>Prevalent pool </li></ul><ul><li>The population with </li></ul><ul><li>AUD’s is a heterogeneous </li></ul><ul><li>and dynamic mix </li></ul><ul><li>Treatment must reflect this diversity and be </li></ul><ul><li>readily available, </li></ul><ul><li>flexible and </li></ul><ul><li>responsive. </li></ul>Stage of Change? Binge drinking Depression Loss of control
  2. 2. Presents a clear, focused message that is easy to understand <ul><li>This slide is intended to highlight the heterogeneity of need for alcohol interventions. The glass represents all drinkers with Alcohol Use Disorders (AUD’s) and shading represents the gradient between hazardous / harmful and dependent consumption. Binge drinking is located within the AUD spectrum. </li></ul><ul><li>The prevalent pool is a dynamic entity, influenced, not only by incidence and survival / duration of disorder, but also by individuals’ relapses / remissions. </li></ul><ul><li>The need for alcohol treatment may not always be felt, or expressed effectively. Individuals may respond to intervention, or request help, at differing thresholds of need, depending on various interacting factors. </li></ul>
  3. 3. Pleasing to the eye! <ul><li>It may seem inappropriate to deploy such imagery, however, it is designed to remind about the omnipresence of alcohol, its widespread acceptance and the subtle interface between safe and harmful use. </li></ul><ul><li>The addictive properties of alcohol are mediated by powerful neural pathways within the brain, which facilitate the reward function and alcohol-seeking behaviour that characterise dependence . There is evidence that visual cues play a significant role in stimulation of reward-anticipation pathways; these unavoidable cues are one of many threats to sustained recovery. </li></ul>
  4. 4. Has the clear potential to help a decision be made <ul><li>This slide was part of a presentation from an alcohol treatment Needs Assessment, focusing on Screening and Brief Interventions in Primary Care settings (in a large, predominantly urban PCT). </li></ul><ul><li>It’s purpose was to illustrate the complexities of planning a responsive treatment service, which maximises service utilisation and benefit. </li></ul><ul><li>It is vital to understand the needs of those who could potentially benefit from intervention, and to take account of the relapsing and remitting nature of alcohol use disorders. Prochaska and Diclemente’s Stages of Change model may be particularly illuminating, in the context of the deployment of motivational interviewing techniques, such as brief interventions. </li></ul><ul><li>Opportunities for intervention may be transient and frontline staff may require additional training in identifying and addressing need. </li></ul><ul><li>Over a given number of years, a core membership of the pool will remain static, but even within that group, at the individual level, risk level and motivation for change may fluctuate and while some may access treatment once or more, others never will – thus it is difficult to predict the optimum capacity of treatment services. </li></ul>
  5. 5. Demonstrates one or more of the 10 public health competencies <ul><li>I completed a Health Needs Assessment relating to alcohol treatment (focusing on screening & brief interventions [SBI] in primary care settings). The report included: </li></ul><ul><li>estimates of the prevalence/utilisation ratio (dependent drinkers in treatment, a technique developed by Tom Phillips, in the UK ANARP report) and </li></ul><ul><li>estimates of potential treatment need, based on modelling. </li></ul><ul><li>This slide was an illustrative way of conveying the diversity of treatment needs, as a reflection of the complexity of alcohol use disorders – it was intended to stimulate discussion about how treatment pathways need to facilitate responsive, flexible and repeatable interventions. It is a way of advocating for better awareness of the very challenging nature of alcohol use disorders and the many social, interpersonal and extraneous factors that can conspire to impede recovery. [email_address] </li></ul>

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