Patient Encounter 1

BB, a 48-year-old man with a history of hypertension, presents to your clinic for follow-up evaluation of his hypertension. You notice that he admits to drinking between one-half to one pint of whiskey daily. He says he drinks more on the weekends, but he drinks every day. When you question him about his drinking, he says that he does not think that it is a problem but admits that his wife has told him he needs to "cut down." He does not believe that he is alcohol dependent because on work days he never drinks before 5 PM. He admits to having had occasional blackouts.

What information would suggest that this patient might be alcohol dependent?

What additional information would you need to determine if he meets the criteria for alcohol dependence?

The criteria for abuse indicate an established pattern of using a substance that has resulted in undesirable family, job, or legal consequences, such as recurrent instances of neglecting school, work, or family responsibilities, or being arrested for driving under the influence. However, abuse becomes dependence when tolerance to the drug, withdrawal from the drug, or an inability to discontinue use of the drug is apparent or there is a loss of control over its use or the use has become compulsive. The criteria for substance dependence from the DSM-IV-TR are listed in Table 36-1.8

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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