Deck 5: Substance Use Assessment and Domestic Violence Assessment

Question 1

Identify current statistics related to alcohol use and abuse.

Answer 1

In 2008, slightly more than half (51.6%) of Americans aged 12 or older reported being current alcohol drinkers (USDHHS, 2009). More than one fifth (23.3%) of persons age 12 or older were binge drinkers ( $\geq$ 5 drinks per occasion) and 6.9% reported heavy drinking (binge drinking on at least 5 days in the past 30 days).

Question 2

Identify risk factors associated with increased alcohol use.

Answer 2

Morbidity and mortality data reflect the adverse consequences of excessive alcohol use. Alcohol is involved in 40% of the 41,000 annual deaths due to traffic crashes (NIH, 2006). The number of emergency department (ED) visits attributable to alcohol from the period 1992 to 2000 was about 68.6 million (McDonald, Wang, Camargo, 2004), with an increasing trend of 18% during that time. In the general population, alcohol consumption of at least four standard drinks per day (each containing 12 g alcohol) is associated with increased rates of death from cirrhosis and alcoholism; and from cancers of the mouth, esophagus, pharynx, and liver combined; and injuries and other external causes in men (Thun et al., 1997).

Question 3

Identify current statistics related to drug and abuse.

Answer 3

In 2008 about 8% of Americans aged 12 or older reported current (past month) illicit drug use (USDHHS, 2009). Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type drugs used nonmedically. Marijuana was the most commonly used illicit drug with 6.1% of persons aged 12 or older reporting past month use. Among youth aged 12 to 17 years, between 2002 and 2008, the rates of use of illicit drugs in general declined significantly (from 11.6% to 9.3%).

Question 4

Incorporate the use of alcohol and drug abuse tools into the assessment of patients in the health care environment.

Question 5

Identify and assess substance abuse in individuals across the life span.

Question 6

Recognize health care professionals' role as mandatory reporters of abuse.

Question 7

Discuss the health effects of violence.

Question 8

Describe the use of the Abuse Assessment Screen (AAS) when one is screening for intimate partner violence.

Question 9

Explain the aspects of assessment and history taking for suspected abuse.

Question 10

Describe the components of the physical examination of the known survivor of IPV or elder abuse and use correct forensic terminology.

Question 11

Discuss the importance of and procedures for both written and photographic documentation of IPV and elder abuse.

Question 12

Assess for the risk of homicide when working with suspected IPV cases.

Question 13

Determine what steps to take if a patient denies IPV but abuse is still suspected.