Alcohol and other drugs 1

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Unit 617

November 2024

Alcohol and other drugs 1

The purpose of this activity is to provide you with an understanding of the management of patients’ substance use and the potential harms from this use and to support positive behaviour change.

Alcohol and other drug use is common in Australia. Although the use of alcohol and other drugs is not always harmful, it can have significant negative effects on the health and wellbeing of all our patients, both those who use them and their families, friends and communities. Even when people are experiencing issues with alcohol and other drugs and attend our general practices, they are often not the presenting complaint. There are many reasons for this, including not knowing where to go for help; lack of insight; not realising that general practitioners can help; and shame, stigma or embarrassment.

Alcohol and other drugs can affect people of all ages from all communities and all walks of life. It is part of our role as general practitioners to screen our patients for substance use and potential harms from this use and to support positive behaviour change.

We also treat the sequelae of these harms and provide advice, support and referral as required.6 Substance use can lead to long-term chronic conditions, and we, as general practitioners, who provide whole-person care and are trusted by the patients we see and assist throughout their lives, are integral to helping them achieve long-term improved health outcomes.

Learning outcomes

At the end of this activity, participants will be able to:

  • identify the treatment options for young people with nicotine dependence
  • explain the role of general practitioners in managing alcohol withdrawal
  • describe the important role general practitioners play in supporting families with loved ones experiencing alcohol and other drug issues
  • outline the assessment and treatment of people experiencing chronic pain who have developed opioid dependence
  • discuss the management of benzodiazepine withdrawal in the general practitioner setting.

Case studies

Below is a list of the case studies found in this month's unit of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

Josie presents with her daughter Mia, aged 15 years. You have known the family for years and cared for Josie through her pregnancy with Mia. You have seen Mia for acute childhood illnesses and vaccinations. You know that Josie separated from Mia’s father 18 months ago, and you have been treating Josie for anxiety and low mood. The family home has just been sold, and Mia had to change schools. Josie says that Mia has been really struggling lately. She seems irritable and angry, and her grades have worsened. Yesterday, Josie got a call from the school informing her that Josie had skipped classes and left the school grounds during school hours.

Pauline, aged 42 years, has been your patient for several years. She is a single mum of three young children and works full-time as a financial advisor. You notice that she seems more anxious than usual and she is not wearing any make-up, which is unlike her.

Pauline tells you she feels tired all the time and requests a blood test as she was iron deficient after her third child was born. She admits that her sleep has been broken and that she has been arguing with her ex-husband, who she believes is not taking enough responsibility for the children. She says she drinks wine to help her unwind and get her off to sleep once the children are in bed.

Belinda, aged 57 years, comes to see you at your general practice. You know Belinda well and have seen her over the past five years for management of hypertension and osteoarthritis. Belinda recently had a sore tooth and consulted her dentist, who said the tooth appeared bruised, possibly from grinding. He advised Belinda to see her general practitioner for stress management.

Belinda admits there is tension at home. Belinda’s daughter Ashleigh, aged 32 years, moved back home four months ago when Ashleigh’s marriage broke down. Ashleigh has been irritable and difficult to talk to, is drinking increasing amounts of alcohol and tends to fall asleep on the couch instead of going to bed. Ashleigh does not help with household chores or contribute financially to groceries or utilities and spends her time at home either on her phone or watching television.

Noah, a man aged 53 years, has recently become your patient following the retirement of his general practitioner, your colleague. Noah comes to see you for a repeat of his regular medications, including pain medications. He has a history of hypertension and gout, for which he takes perindopril 8 mg daily and allopurinol 300 mg daily. Noah has a history of chronic back pain. He feels his current pain medications, which he has been taking for four years, are working well. He has no cravings for other medicines, is not attending early for prescriptions and is not using the medications other than the way the pharmacist has directed him. He reports missing his medications previously and feeling ‘terrible’; developing flu-like symptoms, including a runny nose and eyes; and experiencing ‘unbearable’ pain.

Kelly, aged 62 years, has been coming to your surgery for 10 years. She has had two recent falls at her home, both resulting in minor injuries. She says she is constantly tired and unfocused and is sleeping poorly. She has a history of hypertension, mild bronchiectasis, depression and panic disorder. General medical work-up for her current symptoms reveals no physical cause. She has three adult children and lives in rented accommodation with her oldest daughter, Elise, and grandson Jordan, aged four. Kelly separated from her husband eight years ago after experiencing many years of emotional and physical abuse from him. She has had no ongoing contact with him since this separation but continues to experience considerable anxiety dating back to this abusive relationship. Despite the trauma Kelly has endured, her strength and resilience are apparent. Kelly spends most of her time at home, looking after Jordan when Elise is at work. Kelly’s daughter comes in to the consult with her today, urging her mother to talk to you about ‘the extra pills’ she takes on some days to cope. You note that Kelly’s current medications are listed as perindopril 5 mg daily and oxazepam 30 mg daily. Kelly tells you that she started to attend another practice a year ago to obtain scripts for alprazolam and is taking 2 mg of alprazolam daily and 30 mg of oxazepam twice daily. She was seeking relief from her insomnia, lack of focus and anxiety but feels that her poor sleep and fatigue have worsened in the past year.

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ 鲍鱼视频al Activities and five hours’ Reviewing Performance. 
鲍鱼视频al
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

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  3. Select the course and register

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