S K Haldar CLI Mumbai Notes

1. Alcohol
The interactionof heavydrinkersrelatedproblems&dependence of Alcohol.
Definition:- Substance Misuse Problem(SMP):- Te employee withSubstance Misuse Problemis
definedasthose workerswhoseregularorintermittentuse of substance repeatedlyinterfereswith
theirworkor the work of others,theirjobperformance ortheirabilitytowork,theirrelationshipwith
colleaguesorclients,of theirhealth.
Dependency:- Dependence isastate in whichanindividual experiencesdifficultyincontrollingthe
intake of the substance & experienceswithdrawal symptoms onreductionorcessationof intake.
BloodAlcohol Interpretation
25-50 Mg/Dl Risktakingincreases&decisionmakingskillsbegintodecline
60 Mg/Dl (4 Units) Double the riskof accidentcomparedto those whohas nobloodalcohol
100Mg/Dl (7 Units) 6 timesmore riskof accidents
150Mg/Dl (10 Units) 25 timesmore riskof accidents
Social Drinkers:- Consumptionof alcohol below50 unitsperweek. Above 50units/wk impairsCerebral
functions.
Health Hazards:- 1) Dementiaisthe earlysignincluding:-
a) Impairedproblemsolving
b) Rigidityof thoughts
c) ImpairedRecentMemory
d) Difficultyincarryingoutfine tasks
2) Impairmentof central functions
3) Epilepsy:- Drinkerswhodevelopdependencyof alcohol maydevelopseizures
knownas ‘ RumFits”
4) Absentism
5) Mortalitydue to accidents, HepaticCirrhosis
Diagnosis:- 1) SerumGamma Glutamil Transferase (GGT):- Itremainsabove 45IU/Lit inblood,in
livercirrhosis&ChronicAlcoholism
2) SerumAspartate AminoTransferase:- Increasesincirrhosis&ChronicAlcoholism
If both of the above are raisedtogetherthenita strongindicationthatthe personis
takingheavyalcohol.
Drinkerswithtrouble tofamily&Police orhealth
Problems
Heavy
Drinkers
DependentWorker

2. WHO Guidelines:- Alcohol Use DisordersIdentificationTests(AUDIT)
NonClinical Scanning:-
1) How oftendue youhave a drinkcontainingalcohol? * * * * *
0 1 2 3 4
0:- Never 1:- Monthlyor Less 2:- 2-4 timesina month 3:- 2-3 timesina week
4:- 4 or more timesaweek
2) How manydrinkscontainingalcohol doyouhave ona typical daywhenyouare drinking?
0 = 1-2 1 = 3-4 2 = 5-6 3 = 7-9 4 = 10 or more
3) How oftendoyou have 6 or more drinksonone occasion?
0 = Never 1 = Lessthan monthly 2 = More than monthly 3 = Weekly
4 = Dailyor AlmostDaily
4) How oftenduringthe lastyearhave you foundthatyou are not able to stopdrinkingonce
youhad started?
0 = Never 1 = More than a month 2 = Monthly
5) How oftenduringthe lastyearhave you failedtodowhatwas normallyexpectedfromyou
because of drinking?
Score same as 4.
6) How oftenduringthe lastyearhave youneededafirstdrinkinthe morningtoget yourself
goingaftera heavydrinkingsession?
Score same as 4.
7) How oftenduringthe lastyearhave you hada feelingof guiltafterdrinking?
Score same as 4.
8) How oftenduringthe lastyearhave youbeenunable torememberwhathappenedinthe
nightbefore,because youhadbeendrinking?
Score same as 4.
9) Have you or some one else beeninjuredasaresultof your drinking?
Score same as 4.
10) Has a relative orfriendora doctoror anotherhealthworkerbeenconcernedaboutyour
drinkingorsuggestedthatyoushouldcutdown?
0 = No 2 = Yes butnot inlast year 4 = Yesinthe lastyear