"His best friend was Alcohol.. I wanted my best friend back" - Diagnosing Alcohol Use Disorder (Part I)

In this episode, Dr. Barenboim and Dr. Holt explore a couple's journey through a changing relationship to alcohol and when it became an alcohol use disorder.

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=== Outline ===

Chapter 1: Early Development of a Relationship with Alcohol

Chapter 2: Diagnosing AUD

Chapter 3: Approaching the Conversation

Chapter 4: Motivational Interviewing

=== Learning Points ===

1. Someone’s relationship with alcohol is shaped by many factors. Learning more about these elements--such as upbringing, social circles, and if alcohol is used to cope with stressors--will provide a comprehensive biopsychosocial understanding about the role that alcohol plays in a patient’s life.
2. Be familiar with and use screening tools for excessive alcohol use. These might include the AUDIT-C or the NIAAA Single Alcohol Screening Question.
3. Motivational interviewing not only allows us to understand more about someone’s relationship with alcohol, but provides the guiding framework to explore what they are willing to take on in terms of change and intervention. A key aspect of motivational interviewing in this context is eliciting the patient’s perspectives on what is beneficial and detrimental about their alcohol use, and pointing out the discrepancies in alcohol’s impact on their life.

=== Our Expert(s) ===

Dr. Stephen Holt attended Columbia University’s College of Physicians & Surgeons and subsequently completed his residency training and Chief Residency at Yale's Primary Care Internal Medicine Residency Program before joining the program as an Assistant Professor. He currently serves as the Associate Program Director for Ambulatory Education in the Primary Care Program. His areas of interest include addiction medicine, medical education, and the art and science of physical diagnosis.

=== References ===

1. What is a standard drink? https://www.niaaa.nih.gov/alcohols-effects-health/what-standard-drink
2. Highlights for the 2022 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdf
3. Facts About U.S. Deaths from Excessive Alcohol Use: https://www.cdc.gov/alcohol/facts-stats/index.html
4. AUDIT-C: https://www.mirecc.va.gov/cih-visn2/Documents/Provider_Education_Handouts/AUDIT-C_Version_3.pdf
5. AUDIT: https://auditscreen.org/

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Dylan Balter

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Puddle of Infinity, Adam MacDougall, Density & Time, Jesse Gallagher, Asher Fulero, Astron, Lauren Duski,

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