Alcohol

• The threshold for alcohol consumption is 14 units a week spread evenly over 3 days or more:

  • Hazardous drinking = more than 14 units a week
  • Harmful drinking = pattern of drinking directly causing physiological complications
  • Alcohol dependence = craving and tolerance of alcohol consumption despite the negative complications experienced
• Withdrawal symptoms can be experienced after a few hours of cessation:

  • 6-12 hours: tremors and autonomic arousal (tachycardia, fever, pupillary dilation and sweating)
  • 12-48 hours: alcohol hallucinosis - typically auditory or tactile
  • 72-96 hours: delirium tremens - altered mental status, agitation, and tactile hallucination
• Relevant laboratory investigations in the context of alcohol misuse include:

  • Full blood count: raised MCV, raised platelets, anaemia
  • Liver function tests: increased GGT, AST:ALT > 2:1
  • Haematinics (B12/folate): alcohol can cause folate deficiency
  • Thyroid function tests