Psych CASC / OSCE · Addiction psychiatry
Addiction in older adults — CASC communication station
MRCPsych/FRANZCP-style communication station: non-stigmatising engagement, explain age-related harm and falls, reject abrupt stop of zopiclone plus alcohol, negotiate screening and gradual plan, involve family constructively.
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Station brief
Format. Communication and shared decision-making station, approximately 7–10 minutes after reading time. You are the psychiatry registrar in clinic. [1]
Candidate instructions. Engage without stigma, explain why alcohol plus zopiclone raise falls and cognitive risk in later life, refuse unsafe same-week cold turkey, outline a gradual collaborative plan (screening, sleep alternatives, possible alcohol reduction/pharmacotherapy later), involve the son as support, and safety-net. Do not invent statute numbers. [2][3]
References5ShowHide
- [1]Lehmann SW, Fingerhood M. Substance-Use Disorders in Later Life N Engl J Med, 2018.PMID 30575463
- [2]Kuerbis A, Sacco P, Blazer DG, et al. Substance abuse among older adults Clin Geriatr Med, 2014.PMID 25037298
- [3]Tannenbaum C, Martin P, Tamblyn R, et al. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial JAMA Intern Med, 2014.PMID 24733354
- [4]Glass J, Lanctôt KL, Herrmann N, et al. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits BMJ, 2005.PMID 16284208
- [5]Schonfeld L, King-Kallimanis BL, Duchene DM, et al. Screening and brief intervention for substance misuse among older adults: the Florida BRITE project Am J Public Health, 2010.PMID 19443821