Guideline for the Management of Acute Alcohol Withdrawal Syndrome (AWS)

Size: px
Start display at page:

Download "Guideline for the Management of Acute Alcohol Withdrawal Syndrome (AWS)"

Transcription

1 Derby Hospitals NHS Foundation Trust Guideline for the Management of Acute Alcohol Withdrawal Syndrome (AWS) Background Reference No: CG-T/2007/063 Alcohol Withdrawal Syndrome (AWS) occurs with sudden cessation after longterm use of ethanol, varies in severity and may represent a medical emergency Improved detection of alcohol misuse is essential for better outcomes (Consider using FAST questionnaires see page 2) Violent incidents fall by nearly 50% with increased awareness of alcohol withdrawal and its management Wernicke s Encephalopathy (WE) is a nutritional disorder (thiamine depletion) that Is exacerbated by alcohol and poor diet and is a medical emergency in its own right. It may be undetectable or be almost impossible to diagnose whilst the patient is still intoxicated. Presentations may be subclinical without classic triad of symptoms. Untreated patients with WE have a 10-20% mortality rate and of those surviving WE without treatment, 80% have Korsakoff psychosis and are permanently disabled. Delirium tremens (DTs) occurs in about 5% of patients during withdrawal, usually 2 to 5 days after cessation or rapidly decreased intake. DTs are fatal in 15-20% of inappropriately managed patients. Good prophylactic management will reduce incidence of DTs significantly (see algorithm) % of patients with Alcohol withdrawal fits will progress to DT s without adequate treatment. DT s are the most severe form of AWS with severe autonomic derangement. Hallucinations are often extreme. Electrolyte disturbances are common in malnutrition and excessive alcohol use and should be sought and treated combinations of low potassium, magnesium and phosphate usually occur. Aims and Scope This is a Trust wide guideline aiming to minimise morbidity and mortality, and maximise patient comfort and reduce agitation through: Better recognition of alcohol misusers Identification of groups with or at risk of potentially life threatening complications. Prompt initiation of adequate and timely medical management. Consistency of Detoxification prescribing between clinical settings Avoiding starting treatment too late, with sub-optimal doses resulting in under-sedation, increased agitation and cumulative risks. Patients identified by this algorithm as suffering from severe alcohol withdrawal, delirium tremens and/or associated severe electrolyte imbalance should be managed on Ward 30 at the City Hospital in an HDU/ITU setting where staff are experienced in the management of this condition. CG-T/2007/ 063 Page 1 of 8 Review Date: 2009

2 In order to recognise a potential problem, First take an adequate Alcohol History Use these simple questions and the table of beverages or use the FAST screening tool then apply this information to the two algorithms outlining appropriate treatment for alcohol withdrawal and Wernicke s encephalopathy. Do you drink alcohol? What do you drink? illicit the strength ABV of the beverage if known or brand name. How often in a week would you drink and how much? average out in units per week. If you are under stress do you drink more than this? Re-evaluate answer above How long have you been drinking this much (if higher than recommended levels but under 10u / day woman, 15u day men consider value of Brief Intervention) if over 10 / 15u /day levels regular pattern over two weeks or more or if has a binge drinking pattern that extends over 4 days at a time with withdrawal features in between look to protocol. Any history of alcohol related fits or seizures? Any history of shaking, sweating, fear on cessation. Recent Diet / appetite & Sleep pattern. Are any antidepressant or benzodiazepines being used? Review rationale for prescribing Repeated self harming, suicidal ideology / intent Reported and observed physiological symptoms CG-T/2007/ 063 Page 2 of 8 Review Date: 2009

3 Fast Screening Alcohol Harm Reduction (Screening tool used to identify hazardous drinkers and refer harmful drinkers to Alcohol Misuse Treatment Services) For the following questions, please circle the answer, which best applies; 1 Drink = ½ pint of beer (3.5% abv) or 1 standard glass of wine (125 ml at 9% abv) or 1 single measure of spirits (25ml at 40% abv) 1. Males; how often do you have 8 or more drinks (e.g. 4 pints) on one occasion? Females; How often do you have 6 or more drinks on one occasion? 0. Never.1. Less than monthly 2. Monthly 3. Weekly 5. Daily/almost daily 2. Males; How often do you have 50 or more drinks (e.g. 25 pints) in a week? Females; How often do you have 36 or more drinks in a week? 0. Never. 1. Less than monthly 2. Monthly 4. Most weeks 6. Every week 3. How often during the last year have you been unable to remember what happened the night before, because you were drinking? 0. Never. 1. Less than monthly 2. Monthly 4. Weekly 6. Daily/almost daily 4. How often in the last year have you failed to do what was normally expected, because of your drinking? 0. Never. 1. Less than monthly 2. Monthly 4. Weekly 6. Daily/almost daily 5. In the last year has a relative or friend, or a doctor or health care worker ever been concerned about your drinking and suggested you cut down? 0. No 1. Yes, on one occasion 4. Yes, on at least 3 occasions 6. Yes, on more than 5 occasions Advice: A score of 3 or more indicates probable hazardous drinking and appropriate advice should be given. Referral: A score of 12 or more indicates possible harmful drinking and referral to appropriate service(s) should be made. CG-T/2007/ 063 Page 3 of 8 Review Date: 2009

4 Take an Adequate Alcohol History & Establish current intake. Uncontrolled when printed There is no need to treat individuals who have only abused for a few days and do not have objective signs of AWS unless known clinical history suggests otherwise ie AWS seizures. For periodic drinkers with heavy bouts for week or less inform patient they may feel nervous / anxious and have trouble sleeping for a few nights. All Patients must have the following investigations and followed up as a matter of urgency U & E s K, Mg & PO 4 LFT s + GGT FBC Clotting Screen Blood Glucose Folate / B12 Ethanol or Breath Alcohol Content if monitor is accessible Are there any features Alcohol Withdrawal? Anxiety / agitation / irritability Sweating Tremor in hands / tongue / eyelids Tachycardia Insomnia Anorexia Visual / tactile hallucinations that can be challenged Fever Mild systolic hypertension Nausea / vomit / retch YES prescribe Atenolol 50 mg od for 5 days unless contraindicated Are the any risk factors for progression to severe withdrawal? (Any one of the following) High Regular Established Alcohol intake (>15 u / day men > 10 u / day women) High levels of anxiety Sweating History of severe withdrawal History of seizures / DT s Respiratory alkalosis High regular daily intake with low blood alcohol level Poor physical health Insomnia YES No treatment necessary but continue to monitor. AWS usually begin 4-12 hours after cessation but may take up to a day or two, -usually peaking in intensity by day2 Are there any symptoms of Autonomic over activity? Paranoid ideas Severe Hallucinosis Severe confusion Profuse sweating Severe agitation Tachypnoea YES Presume Severe AWS or DT s MEDICAL EMERGENCY 1) Give IV Lorazepam 1-2mg (repeat every 10 mins as required) (use monitoring sheet - see intranet) and initiate Chlordiazepoxide 50mg po qds 2) Administer I.V Pabrinex High Potency (HP) (see over) Chlordiazepoxide regime prescribed on variable dose section and vitamin supplementation should always be considered alongside see over Discharge medication Chlordiazepoxide as a TTO should not be considered unless: A suitable supportive home environment exists. Patient is safely established on detox regime And that; Continued commitment to ongoing abstinence has been established as a goal. Time Very Severe symptoms only mg 30mg 20mg 20mg 20mg 10mg 10mg S mg 30mg 20mg 10mg 10mg 10mg T mg 30mg 20mg 10mg 10mg 10mg 10mg O mg 30mg 20mg 20mg 20mg 10mg 10mg 10mg P Initial dose should be titrated up to meet clinical signs. Initial 30mg QDS is sufficient for almost all cases but may need up to 50mg QDS to control very severe symptoms, therefore an extra day of detoxification may be required as indicated above. Mild presenting symptoms consider starting detox as per 2 and observe. Regular recorded T & BP and observe for breakthrough AWS. Severity of withdrawals do not correlate simply with consumption levels. Caution care in liver disease, respiratory depression, renal impairment or >70years CG-T/2007/ 063 Page 4 of 8 Review Date: 2009

5 Management Algorithm for Electrolyte and Vitamin Supplementation & Prevention and / or Treatment of Wernicke s Encephalopathy Every patient prescribed Chlordiazepoxide- reducing regime should have One dose of 1 ampoule pair Pabrinex High Potency (HP) Vitamins I.V (To initialise treatment, prophylaxis or to counter sub-clinical presentations) Check haematology and K/Mg/PO 4 results (see refeeding/phosphate guidelines on intranet) Mg is essential for the conversion of thiamine into its active form (thiamine pyrophosphate) and levels may be reduced when higher doses of IV Pabrinex are used. Serum levels <0.50 mmol should be corrected intravenously Are any one of the following list present? Acute confusion Decreased Consciousness Memory disturbance Unexplained hypotension with hypothermia Ophthalmoplegia Nystagmus Ataxia YES Presume Wernicke s encephalopathy 2 pairs ampoules Pabrinex HP IV TDS for 2 days. Are there any further Risk Factors that suggest Wernicke s encephalopathy? Intercurrent illness Symmetrical Peripheral Neuropathy Drinking >20u daily Recent protracted vomiting / diarrhoea Signs of malnutrition DT s or Treatment for DT s Alcohol related seizures Poor diet YES Enduring dietary intolerance, ataxia, poly neuritis or memory disturbance continue 1 Pair Pabrinex IVHP OD for 5 days or as long as improvement continues then oral dosing Risk of W.E 1 Pair ampoules Pabrinex HP IV O.D for 3 days then oral dosing Commence oral dosing Bibliography: Oral dosing and discharge medication: Thiamine oral 50mg QDS ) Vitamin B Co Strong 2 tabs OD ) to complete 28 days including inpatient treatment Folic Acid 5mg daily Continue for three months in peripheral neuropathy and add pyridoxine 20mg OD CG-T/2007/ 063 Page 5 of 8 Review Date: 2009

6 CG-T/2007/ 063 Page 6 of 8 Review Date: 2009

7 Ambrose ML, Bowden SC Whelan G. Thiamin treatment and working memory function of alcohol-dependent people: preliminary findings. Alcohol Clin Exp Res 2001;25(1) Ashol J (2004) Withdrawal Syndromes Available online Chataway J (1995) Letters to the Editor, Thiamine in Wernicke s syndrome- how much and how long? Postgraduate Medical Journal. Vol Cook CCH, Hallwood PM, Thomson A (1998) invited review B vitamin deficiency and neuropsychiatric syndromes in alcohol misuse. Alcohol & Alcoholism vol Dancy M, Evans G, Gaitonde MK, Maxwell JD (1984) Blood thiamine and thiamine phosphate ester concentrations in alcoholic and non alcoholic liver diseases British Medical Journal Vol E, Bentham P, Callaghan R, Kuruvilla T, George S (2003) Thiamine for Wernicke-Korsakoff Syndrome in people at risk from over-consumption of alcohol (Protocol for a Cochrane Review). In: The Cochrane Library, Issue 3, Oxford De Angelo A, Halliday A (2002). Wernicke-Korsakoff Syndrome Online Accessed 27/11/03 US Derby Hospitald NHS Foundation Trust (Twine P) (2005 ) Guidelines for Phosphate Replacement in Refeeding Syndrome and Malnourished Patients CG-T/2005 V2.0 DHNHST Harper C, Giles m and Finlay-Jones R (1986) Clinical signs in the Wernicke- Korsakoff Complex: a retrospective analysis of 131 cases diagnosed at necropsy. Journal of neurology, neurosurgery and psychiatry vol Mayo-Smith MF Pharmacetical management of alcohol withdrawal (1997) A meta analysis and evidence based guideline. American society of Addiction Medicine Working Group on Pharmacetical Management of Alcohol Withdrawal. Jama 1997; 278(2) Pirmohamed M (2001), ALCOHOL - can the NHS afford it? Royal College of Physicians RCP London Scottish Intercollegiate Guidelines Network (2003) The management of harmful drinking and alcohol dependence in primary care a national clinical guideline. RCP Edinburgh. Victor M, Adams RD, and Collins GH. (1989) The Wernicke-Korsakoff Syndrome and Related Neurological Disorders due to Alcoholism and Malnutrition.. F.A. Davis Company, Philadelphia Wood B, Currie J (1995) Presentation of Acute Wernicke s Encephalopathy and Treatment with Thiamine Metabolic Brain Disease, Vol Documentation Controls Development of Guideline: Consultation with: Approved by: Hepatology Consultant A&E and ICU Consultants Clinical Guidelines Group Signature: Print Name and Position: Dr. Nick Chesshire, Chair of Clinical Guidelines Group Approval Date: January 2007 Review Date: January 2009 Distribution and location : Key Contact: All wards and Departments Consultant Hepatologist CG-T/2007/ 063 Page 7 of 8 Review Date: 2009

8 Appendix 1 Alcohol Content of Some Beverages Beer / Lager ABV % Measure Units Lynx ml 4.25 Carlsberg Special ml 4.5 Brew / Tennants Super / Amsterdam ml 5.8 Maximator Labatts/ Carling 4.0 Pint 568ml 2.3 Cider Strongbow 4.5 Litre 4.5 Old English 5.5 Pint 3.1 Frosty Jack/ litre 22.5 Zeppelin / white lightening Spirit Vodka / Rum ml 26.3 Absinthe 75 30ml 2.3 Wines ml Useful Contacts: Locally: Mary Johnson, Alcohol Liaison Specialist Nurse City Hospital via switchboard. Web sites: Alcohol Concern, The Portman Group, APAS Nottingham Alternatively, visit your G.P CG-T/2007/ 063 Page 8 of 8 Review Date: 2009

Version 2 This guideline describes how to manage patients who are showing signs and symptoms of alcohol withdrawal and Wernicke s Encephalopathy.

Version 2 This guideline describes how to manage patients who are showing signs and symptoms of alcohol withdrawal and Wernicke s Encephalopathy. Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Contact Name and Job Title (author) Directorate & Speciality A Guideline for the Management of Acute Alcohol Withdrawal

More information

Supported Alcohol Withdrawal Treatment Information

Supported Alcohol Withdrawal Treatment Information Supported Alcohol Withdrawal Treatment Information Alcohol Liaison Service What is Alcohol Withdrawal Syndrome? If you are dependent on alcohol and suddenly stop drinking or you are admitted to hospital

More information

Alcohol Liaison Service. Alcohol Withdrawal. Information

Alcohol Liaison Service. Alcohol Withdrawal. Information Alcohol Liaison Service Alcohol Withdrawal Information Alcohol withdrawal If you are dependent on alcohol and suddenly stop drinking, there are a series of symptoms that you may experience. These include:

More information

Glasgow Assessment and Management of Alcohol

Glasgow Assessment and Management of Alcohol Glasgow Assessment and Management of Alcohol If you would like further information or advice on the alcohol screening and withdrawal management guideline(gmaws) please contact your local acute addiction

More information

ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE

ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE Authors Sponsor Responsible committee Ratified by Consultant Psychiatrist; Pharmacist Team Manager Medical Director Medicines Management Group

More information

Alcohol Dependence Inpatient management of Alcohol Withdrawal

Alcohol Dependence Inpatient management of Alcohol Withdrawal NHS Fife Community Health Partnerships Addiction Services Alcohol Dependence Inpatient management of Alcohol Withdrawal Intranet Procedure No A9 Author Dr. A. Baldacchino Copy No Lead Clinician Implementation

More information

THE BASICS. Community Based Medically Assisted Alcohol Withdrawal. World Health Organisation 2011. The Issues 5/18/2011. RCGP Conference May 2011

THE BASICS. Community Based Medically Assisted Alcohol Withdrawal. World Health Organisation 2011. The Issues 5/18/2011. RCGP Conference May 2011 RCGP Conference May 2011 Community Based Medically Assisted Alcohol Withdrawal THE BASICS An option for consideration World Health Organisation 2011 Alcohol is the world s third largest risk factor for

More information

GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE

GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE Dr Millicent Chikoore MBBS MRCPsych Dr O Lagundoye MBBS MRCPsych Community based alcohol detoxification is a safe and effective option for

More information

Review Group: Mental Health Operational Medicines Management Group. Signature: Signature: Signature: Review Date: June Uncontrolled When Printed

Review Group: Mental Health Operational Medicines Management Group. Signature: Signature: Signature: Review Date: June Uncontrolled When Printed Mental Health NHS Grampian Mental Health Service Staff Guidance For The Prescribing Of Vitamin Supplementation During In-Patient Admission (Mental Health) For Alcohol Withdrawal Lead Author/Coordinator:

More information

Review Group: Mental Health Operational Medicines Management Group. Signature Signature Signature. Review Date: December 2014

Review Group: Mental Health Operational Medicines Management Group. Signature Signature Signature. Review Date: December 2014 Mental Health NHS Grampian Mental Health Service Staff Guidance For The Prescribing Of Vitamin Supplementation During In-Patient Admission (Mental Health) For Alcohol Withdrawal Co-ordinators: Consultant

More information

Alcohol Withdrawal Syndrome & CIWA Assessment

Alcohol Withdrawal Syndrome & CIWA Assessment Alcohol Withdrawal Syndrome & CIWA Assessment Alcohol Withdrawal Syndrome is a set of symptoms that can occur when an individual reduces or stops alcoholic consumption after long periods of use. Prolonged

More information

Alcohol. Problems with drinking alcohol

Alcohol. Problems with drinking alcohol Alcohol Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol. If you are alcohol- dependent then

More information

Alcohol Withdrawal. Mild Withdrawal Moderate Withdrawal Severe Withdrawal. Mild anxiety Malaise Marked anxiety

Alcohol Withdrawal. Mild Withdrawal Moderate Withdrawal Severe Withdrawal. Mild anxiety Malaise Marked anxiety Alcohol Withdrawal Recognition and Assessment Alcohol withdrawal may be a presenting feature or occur as an unexplained development in a patient who has been admitted for other reasons and deprived of

More information

2.6.4 Medication for withdrawal syndrome

2.6.4 Medication for withdrawal syndrome .6.3 Self-medication Self-medication presents a risk during alcohol withdrawal, particularly when there is minimal supervision (low level and medium level 1 settings). Inform patients of the risk of selfmedication

More information

Alcoholism and Problem Drinking

Alcoholism and Problem Drinking Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean 'alcohol dependence' (alcohol addiction). Some people are 'problem drinkers' without being dependent on alcohol.

More information

This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative.

This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative. This document is also available in large print and other formats and languages, upon request. Please call NHS Grampian Corporate Communications on (01224) 551116 or (01224) 552245 This controlled document

More information

A Guide to Alcoholism and Problem Drinking

A Guide to Alcoholism and Problem Drinking A Guide to Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol.

More information

Alcoholism and Problem Drinking

Alcoholism and Problem Drinking Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol.

More information

GP Drug & Alcohol Supplement No.7 May 1997

GP Drug & Alcohol Supplement No.7 May 1997 GP Drug & Alcohol Supplement No.7 May 1997 This is the seventh of the monthly Drug and Alcohol Supplements prepared for Central Coast GPs. Detoxification from Alcohol Dr Tony Gill Introduction The management

More information

Withdrawal. ICGP Summer School June 23 rd 2011 Dr John Cuddihy Ayrfield Medical Practice, Kilkenny

Withdrawal. ICGP Summer School June 23 rd 2011 Dr John Cuddihy Ayrfield Medical Practice, Kilkenny The Management of Alcohol Withdrawal ICGP Summer School June 23 rd 2011 Dr John Cuddihy Ayrfield Medical Practice, Kilkenny Some stats Alcohol dependence 4% of people 16 65 6% of men and 2% 0f women Harmful

More information

INTOXICATED PATIENTS AND DETOXIFICATION

INTOXICATED PATIENTS AND DETOXIFICATION VAMC Detoxification Decision Tree Updated May 2006 INTOXICATED PATIENTS AND DETOXIFICATION Patients often present for evaluation of substance use and possible detoxification. There are certain decisions

More information

SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT ALCOHOL MISUSE

SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT ALCOHOL MISUSE SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT OF ALCOHOL MISUSE Date: March 2015 1 1. Introduction Alcohol misuse is a major public health problem in Camden with high rates of hospital

More information

Outpatient Treatment of Alcohol Withdrawal. Daniel Duhigg, DO, MBA

Outpatient Treatment of Alcohol Withdrawal. Daniel Duhigg, DO, MBA Outpatient Treatment of Alcohol Withdrawal Daniel Duhigg, DO, MBA DSM V criteria for Alcohol Withdrawal A. Cessation or reduction of heavy/prolonged alcohol use B. 2 or more of the following in hours to

More information

Guidance for the Detoxification of Alcohol Dependent Patients in Community or Outpatient Settings

Guidance for the Detoxification of Alcohol Dependent Patients in Community or Outpatient Settings Title: Identifier: Replaces: Guidance for the Detoxification of Alcohol Dependent Patients in Community or Outpatient Settings NHSG/Guid/Detox_ADP/MGPG663 N/A - New document Across NHS Boards Organisation

More information

Alcohol Withdrawal. Introduction. Blood Alcohol Concentration. DSM-IV Criteria/Alcohol Abuse. Pharmacologic Effects of Alcohol

Alcohol Withdrawal. Introduction. Blood Alcohol Concentration. DSM-IV Criteria/Alcohol Abuse. Pharmacologic Effects of Alcohol Pharmacologic Effects of Alcohol Alcohol Withdrawal Kristi Theobald, Pharm.D., BCPS Therapeutics III Fall 2003 Inhibits glutamate receptor function (NMDA receptor) Inhibits excitatory neurotransmission

More information

SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE

SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE 1 P a g e The following Operational Guidance Manual has been prepared with input from both community and prison addictions specialists

More information

Alcohol Dependence and Motivational Interviewing

Alcohol Dependence and Motivational Interviewing Alcohol Dependence and Motivational Interviewing Assessment of Alcohol Misuse Checklist Establish rapport patients are often resistant Longitudinal history of alcohol use Assess additional drug use Establish

More information

Alcohol Withdrawal Syndromes

Alcohol Withdrawal Syndromes Alcohol Withdrawal Syndromes Should You Treat This Patient s Alcohol Withdrawal With Benzodiazepines?! Meta-analysis of RCTs of benzodiazepines for the treatment of alcohol withdrawal! 11 RCTs identified,

More information

STANDARD OPERATING PROCEDURE. Administration of High Dose Muscular Vitamin Supplements for Undergoing Alcohol

STANDARD OPERATING PROCEDURE. Administration of High Dose Muscular Vitamin Supplements for Undergoing Alcohol STANDARD OPERATING PROCEDURE Administration of High Dose Muscular Vitamin Supplements for Undergoing Alcohol DOCUMENT CONTROL: Version: 2 Ratified by: Clinical Effectiveness Committee Date ratified: 03

More information

Alcohol Withdrawal Recognition and Treatment

Alcohol Withdrawal Recognition and Treatment Alcohol Withdrawal Recognition and Treatment Thomas Meyer BS EMS, MICP SREMSC Page 1 Purpose As EMTs a mantle of responsibility is placed upon you to ensure the safety and well-being of those in your charge

More information

CALDERDALE ALCOHOL TEAM & Calderdale Substance Misuse Service COMMUNITY ALCOHOL DETOXIFICATION GUIDELINE

CALDERDALE ALCOHOL TEAM & Calderdale Substance Misuse Service COMMUNITY ALCOHOL DETOXIFICATION GUIDELINE CALDERDALE ALCOHOL TEAM & Calderdale Substance Misuse Service COMMUNITY ALCOHOL DETOXIFICATION GUIDELINE Unique Identifier Number: Approved By: NYA Effective From July 2010 Review Date: July 2012 Review

More information

MANAGEMENT OF ALCOHOL PROBLEMS ON PSYCHIATRIC WARDS

MANAGEMENT OF ALCOHOL PROBLEMS ON PSYCHIATRIC WARDS MANAGEMENT OF ALCOHOL PROBLEMS ON PSYCHIATRIC WARDS This guideline is primarily intended to assist in the medical management of alcohol dependent patients admitted to psychiatric inpatient units. For a

More information

Philip Moore DO, Toxicology Fellow, PinnacleHealth Toxicology Center Joanne Konick-McMahan RN MSRN, Staff RN, PinnacleHealth

Philip Moore DO, Toxicology Fellow, PinnacleHealth Toxicology Center Joanne Konick-McMahan RN MSRN, Staff RN, PinnacleHealth Philip Moore DO, Toxicology Fellow, PinnacleHealth Toxicology Center Joanne Konick-McMahan RN MSRN, Staff RN, PinnacleHealth I. II. Background A. AWS can occur in anyone who consumes alcohol B. Risk correlates

More information

Symptom-Triggered Alcohol Detoxification: A Guideline for use in the Clinical Decisions Unit of the Emergency Department.

Symptom-Triggered Alcohol Detoxification: A Guideline for use in the Clinical Decisions Unit of the Emergency Department. Symptom-Triggered Alcohol Detoxification: A Guideline for use in the Clinical Decisions Unit of the Emergency Department. Dr Eugene Cassidy, Liaison Psychiatry; Dr Io har O Sulliva, E erge cy Department,

More information

Alcohol and Dependence

Alcohol and Dependence The facts about... Alcohol and Dependence Five key things you need to know A glass of wine with dinner, a beer after work, a cocktail in the sunshine on holiday. Alcohol makes an appearance in so many

More information

Audit of Alcohol Detoxification Prescribing Observatory for Mental Health (POMH-UK) Regional Event

Audit of Alcohol Detoxification Prescribing Observatory for Mental Health (POMH-UK) Regional Event Audit of Alcohol Detoxification Prescribing Observatory for Mental Health (POMH-UK) Regional Event Wakefield 4th December 2013 definition and guidance Duncan Raistrick Leeds Addiction Unit Detoxification

More information

GUIDELINES FOR THE MANAGEMENT OF ALCOHOL WITHDRAWAL IN THE ACUTE GENERAL HOSPITAL SETTING

GUIDELINES FOR THE MANAGEMENT OF ALCOHOL WITHDRAWAL IN THE ACUTE GENERAL HOSPITAL SETTING GUIDELINES FOR THE MANAGEMENT OF ALCOHOL WITHDRAWAL IN THE ACUTE GENERAL HOSPITAL SETTING Matthew Cowan Consultant Gastroenterologist April 2013 This document contains recommendations for the management

More information

Title Alcohol Withdrawal Management Guidelines

Title Alcohol Withdrawal Management Guidelines Document Control Title Alcohol Withdrawal Management Guidelines Author Consultant Physicians, Core Medical Trainee and Glossop Ward Manager Directorate Version Date Issued Status 0.1 Dec Draft Initial

More information

NHS FORTH VALLEY. Alcohol Dependence: Community Management of Alcohol Withdrawal

NHS FORTH VALLEY. Alcohol Dependence: Community Management of Alcohol Withdrawal NHS FORTH VALLEY Alcohol Dependence: Community Management of Alcohol Withdrawal Approved 14 / 11 / 2012 Version 2 Date of First Issue April 2008 Review Date 28 / 11 / 2014 Date of Issue 28 / 11 / 2012

More information

Prescribing for substance misuse: Alcohol detoxification

Prescribing for substance misuse: Alcohol detoxification Prescribing for substance misuse: Alcohol detoxification Dr Julia Sinclair Senior Lecturer in Psychiatry University of Southampton Previously: Sensible Hazardous Harmful Dependence Current: Lower Risk

More information

General PROVIDER INITIAL: PHYSICIAN ORDERS. Vital Signs

General PROVIDER INITIAL: PHYSICIAN ORDERS. Vital Signs Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 Discontinue all lorazepam

More information

Joint Trust Guideline for the Management of: Wernicke s Encephalopathy. A clinical guideline recommended for use A+E, Medical and Surgical Wards

Joint Trust Guideline for the Management of: Wernicke s Encephalopathy. A clinical guideline recommended for use A+E, Medical and Surgical Wards A clinical guideline recommended for use In: A+E, Medical and Surgical Wards By: For: All Medical staff Division responsible for document: Divisions 1 and 2 Patients at risk of or with features of Wernicke

More information

This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative.

This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative. Title: Staff Guidelines For The Management Of Alcohol Withdrawal In NHS Grampian Adult ( Age 18) Inpatients Unique Identifier: Replaces: (provided by the NHS Grampian Review Group for Clinical Process

More information

8/23/2016. Managing Alcohol Withdrawal. Disclosures. Objectives. None. This presentation has no current affiliation or financial arrangements.

8/23/2016. Managing Alcohol Withdrawal. Disclosures. Objectives. None. This presentation has no current affiliation or financial arrangements. Managing Alcohol Withdrawal Zachary Hartsell, MHA, PA-C Clinical Associate Professor Disclosures None. This presentation has no current affiliation or financial arrangements. 2 Objectives 1.Explain the

More information

Alcohol Withdrawal Management. Recognition and Management of DTs, Seizures and Wernicke s Encephalopathy

Alcohol Withdrawal Management. Recognition and Management of DTs, Seizures and Wernicke s Encephalopathy Alcohol Withdrawal Management Recognition and Management of DTs, Seizures and Wernicke s Encephalopathy The challenge We need to improve the hospital management of patients with alcohol problems This is

More information

Assessment and management of alcohol dependence and withdrawal in the acute hospital

Assessment and management of alcohol dependence and withdrawal in the acute hospital Assessment and management of alcohol dependence and withdrawal in the acute hospital Concise guidance to good practice series June 01 CONCISE GUIDANCE Clinical Medicine 01, Vol 1, No : 71 Assessment Main

More information

Alcohol Withdrawal in the AMU. Dr Ewan Forrest Glasgow Royal Infirmary

Alcohol Withdrawal in the AMU. Dr Ewan Forrest Glasgow Royal Infirmary Alcohol Withdrawal in the AMU Dr Ewan Forrest Glasgow Royal Infirmary The Society for Acute Medicine, 7 th International Conference, 3-4 October 2013 AWS: The Scale of the Problem Hospital Admissions (England):

More information

Coping With Alcohol Withdrawal

Coping With Alcohol Withdrawal Coping With Alcohol Withdrawal Central and North West London NHS Foundation Trust Addictions Services Alcohol withdrawal When a person is dependent on alcohol and suddenly stops drinking there are certain

More information

Alcohol Use Disorders Information for Patients and Carers

Alcohol Use Disorders Information for Patients and Carers Alcohol Liaison Service Alcohol Use Disorders Information for Patients and Carers Information Drinking too much alcohol greatly increases your risk of serious health problems. Many different health problems

More information

Alcohol withdrawal A challenge in caring for patients after heart surgery

Alcohol withdrawal A challenge in caring for patients after heart surgery Abteilung Praxisentwicklung Pflege Alcohol withdrawal A challenge in caring for patients after heart surgery Wolfgang Hasemann, RN, PhD Deborah Leuenberger, MScN.cand. June 2015 Content Alcohol consumption

More information

Adjunctive psychosocial intervention. Conditions requiring dose reduction. Immediate, peak plasma concentration is reached within 1 hour.

Adjunctive psychosocial intervention. Conditions requiring dose reduction. Immediate, peak plasma concentration is reached within 1 hour. Shared Care Guideline for Prescription and monitoring of Naltrexone Hydrochloride in alcohol dependence Author(s)/Originator(s): (please state author name and department) Dr Daly - Consultant Psychiatrist,

More information

Alcohol information. A standard drink contains about 10g of alcohol takes a healthy liver about 1 hour to remove alcohol from the body.

Alcohol information. A standard drink contains about 10g of alcohol takes a healthy liver about 1 hour to remove alcohol from the body. Alcohol information Facts about alcohol use Alcohol (grog) is the most widely used recreational drug in Australia NT drinks 70% more and WA 25% more than the rest of Australia Alcohol related deaths for

More information

Promoting Self Care for Homeless People who are dependent on alcohol-a case study or a journey depending on your viewpoint

Promoting Self Care for Homeless People who are dependent on alcohol-a case study or a journey depending on your viewpoint Promoting Self Care for Homeless People who are dependent on alcohol-a case study or a journey depending on your viewpoint Pam Campbell Nurse Consultant Homeless Healthcare Team What does self management

More information

New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery

New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery USING THE 48 HOUR OBSERVATION BED USING THE 48 HOUR OBSERVATION BED Detoxification

More information

Alcoholism. Alcoholism is a type of drug addiction. There is both physical and mental dependence on alcohol.

Alcoholism. Alcoholism is a type of drug addiction. There is both physical and mental dependence on alcohol. Alcoholism Alcoholism Alcohol dependence; Alcohol abuse Definition Alcoholism is drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family, or job

More information

CLINICAL GUIDELINE FOR ALCOHOL DETOXIFICATION AND ADMINISTRATION OF CHLORDIAZEPOXIDE AT RCHT 1. Aim/Purpose of this Guideline

CLINICAL GUIDELINE FOR ALCOHOL DETOXIFICATION AND ADMINISTRATION OF CHLORDIAZEPOXIDE AT RCHT 1. Aim/Purpose of this Guideline CLINICAL GUIDELINE FOR ALCOHOL DETOXIFICATION AND ADMINISTRATION OF CHLORDIAZEPOXIDE AT RCHT 1. Aim/Purpose of this Guideline 1.1. Guidance for all clinical staff at RCHT for the treatment of alcohol withdrawal

More information

Prescribing for substance misuse: alcohol detoxification

Prescribing for substance misuse: alcohol detoxification Prescribing for substance misuse: alcohol detoxification POMH-UK Quality Improvement Programme. Topic 14a: baseline Prepared by the Prescribing Observatory for Mental Health-UK for Kent and Medway NHS

More information

Symptom Based Alcohol Withdrawal Treatment

Symptom Based Alcohol Withdrawal Treatment Symptom Based Alcohol Withdrawal Treatment -Small Rural Hospital- Presenter CDR Dwight Humpherys, DO dwight.humpherys@ihs.gov Idaho State University Baccalaureate Nursing Program Lake Erie College of Osteopathic

More information

Alcohol detoxification

Alcohol detoxification Alcohol detoxification A guide to alcohol detoxification for service users and families. Stockton Treatment Alcohol and Recovery Service Alcohol dependence If you are dependent on alcohol then you will

More information

FREQUENCY OF DELIRIUM SYMPTOMS

FREQUENCY OF DELIRIUM SYMPTOMS FREQUENCY OF DELIRIUM Delirium is abrupt onset confusion produced by medical problems or drug toxicity. The term comes from Latin de lira or out of the track and this common clinical entity is frequently

More information

General PROVIDER INITIALS: PHYSICIAN ORDERS

General PROVIDER INITIALS: PHYSICIAN ORDERS Height Weight Allergies If appropriate for patient condition, please consider the following order sets: Initiate Electrolyte Replcement: Med/Surg, Med/Surg Tele Physician Order #842 General Vital Signs

More information

Alcohol and nicotine are widely abused substances and are often used together One study showed that 15% of patients visiting a primary care practice

Alcohol and nicotine are widely abused substances and are often used together One study showed that 15% of patients visiting a primary care practice Dr IM Joubert Alcohol and nicotine are widely abused substances and are often used together One study showed that 15% of patients visiting a primary care practice for any reason had either an at-risk pattern

More information

Box 1: Screening and brief interventions ASSESS elicit patient s concerns how does alcohol fit in? ELICIT AND RECORD typical day s drinking maximum in a day alcohol related physical, emotional and social

More information

Alcohol use disorders: sample chlordiazepoxide dosing regimens for use in managing alcohol withdrawal

Alcohol use disorders: sample chlordiazepoxide dosing regimens for use in managing alcohol withdrawal Alcohol use disorders: sample chlordiazepoxide dosing regimens for use in managing alcohol withdrawal February 2010 NICE clinical guidelines 100 and 115 1 These sample chlordiazepoxide dosing regimens

More information

Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care

Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care Hull & East Riding Prescribing Committee Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care 1. BACKGROUND Patients who are physically dependent

More information

Diagnosis and treatment of Wernicke s encephalopathy in an in-patient alcohol detoxification unit: a completed audit cycle

Diagnosis and treatment of Wernicke s encephalopathy in an in-patient alcohol detoxification unit: a completed audit cycle Diagnosis and treatment of Wernicke s encephalopathy in an in-patient alcohol detoxification unit: a completed audit cycle Vijay Delaffon, 1 Srinivas Naik, 1 Rajandeep Mann, 1 Arshya Vahabzadeh, 2 Timothy

More information

ALCOHOL WITHDRAWAL SYNDROME

ALCOHOL WITHDRAWAL SYNDROME ALCOHOL WITHDRAWAL SYNDROME INTRODUCTION Alcohol is the most commonly abused drug in the United States and when someone who chronically abuses alcohol does not drink, that person is at risk for developing

More information

Care of the Patient Undergoing Alcohol Withdrawal. Meggen Platzar RN, BSN, CMSRN Jennifer Wilhelm RN, BSN, CMSRN

Care of the Patient Undergoing Alcohol Withdrawal. Meggen Platzar RN, BSN, CMSRN Jennifer Wilhelm RN, BSN, CMSRN Care of the Patient Undergoing Alcohol Withdrawal Meggen Platzar RN, BSN, CMSRN Jennifer Wilhelm RN, BSN, CMSRN If you know someone who tries to drown their sorrows, you might tell them sorrows know how

More information

Alcohol addiction treatment

Alcohol addiction treatment Alcohol addiction treatment VERESIES CLINIC offers treatment of alcohol dependence. The program is offered both as an inpatient and outpatient program. It offers an intensive program of personal Psychological

More information

Case. History of psoriatic arthritis, htn, essential tremor Meds: propranolol, etodolac, etanercept No history of prior psychiatric disease.

Case. History of psoriatic arthritis, htn, essential tremor Meds: propranolol, etodolac, etanercept No history of prior psychiatric disease. Case 48 year old man admitted complaining of hallucinations. Mild hallucinations for a year. Worsened tremor for 3 weeks and then markedly worse hallucinations last 2 days History of psoriatic arthritis,

More information

Trust Clinical Policy. Directorate/Department/Specialist Group Emergency Department, Medical Admissions Unit and All wards and Departments

Trust Clinical Policy. Directorate/Department/Specialist Group Emergency Department, Medical Admissions Unit and All wards and Departments Trust Clinical Policy Directorate/Department/Specialist Group Emergency Department, Medical Admissions Unit and All wards and Departments Title Individualised Treatment for Acute Alcohol Withdrawal and

More information

Management of alcohol withdrawal including the Symptom triggered CIWA score

Management of alcohol withdrawal including the Symptom triggered CIWA score Management of alcohol withdrawal including the Symptom triggered CIWA score Classification: Policy Lead Author: Ruth Brown Alcohol specialist Nurse Additional author(s): Hailey Pennington Authors Division:

More information

OUT-PATIENT DETOX CLINIC NEIL TURNER: ALCOHOL LIAISON NURSE

OUT-PATIENT DETOX CLINIC NEIL TURNER: ALCOHOL LIAISON NURSE OUT-PATIENT DETOX CLINIC NEIL TURNER: ALCOHOL LIAISON NURSE Introduction Admissions to hospital for alcohol detoxification in Skye and Lochalsh have been up to 78% higher than national average (www.scotpho.org))

More information

3 rd most deprived area Registered population 240,000 Young population Growth of 30,000 in next 5 years Highest increase will be in working age 34%

3 rd most deprived area Registered population 240,000 Young population Growth of 30,000 in next 5 years Highest increase will be in working age 34% THCAT 3 rd most deprived area Registered population 240,000 Young population Growth of 30,000 in next 5 years Highest increase will be in working age 34% Bangladeshi (much higher in under 20s) Recent data

More information

PHYSICIAN ORDERS. Alcohol Withdrawal [3040000935] Alcohol Withdrawal [3040000935] Height Weight Allergies

PHYSICIAN ORDERS. Alcohol Withdrawal [3040000935] Alcohol Withdrawal [3040000935] Height Weight Allergies Height Weight Allergies Please consider these other order sets: -Medical-Surgical Electrolyte Replacement -Critical Care Electrolyte Replacement General Discontinue all previously ordered benzodiazepines

More information

1. According to recent US national estimates, which of the following substances is associated

1. According to recent US national estimates, which of the following substances is associated 1 Chapter 36. Substance-Related, Self-Assessment Questions 1. According to recent US national estimates, which of the following substances is associated with the highest incidence of new drug initiates

More information

CAGE. AUDIT-C and the Full AUDIT

CAGE. AUDIT-C and the Full AUDIT CAGE In the past have you ever: C tried to Cut down or Change your pattern of drinking or drug use? A been Annoyed or Angry because of others concern about your drinking or drug use? G felt Guilty about

More information

acute alcohol withdrawal (which occurs if a 'dependent' drinker suddenly stops drinking)

acute alcohol withdrawal (which occurs if a 'dependent' drinker suddenly stops drinking) Physical health problems caused by drinking alcohol Information for the public Published: 1 June 2010 nice.org.uk About this information NICE clinical guidelines advise the NHS on caring for people with

More information

Quality and Patient Safety Division

Quality and Patient Safety Division Commonwealth of Massachusetts Board of Registration in Medicine Quality and Patient Safety Division Advisory Alcohol Screening and Management Protocols July 2013 Background The Quality and Patient Safety

More information

Specialized terms used in this workbook and their meanings:

Specialized terms used in this workbook and their meanings: Glossary Specialized terms used in this workbook and their meanings: Absorption: The way alcohol enters the bloodstream. Alcohol is absorbed into the blood through the stomach and small intestine. Addiction:

More information

5/6/2016. Alcohol Withdrawal. How long has it been around? Some Strategies in Diagnosis and Treatment

5/6/2016. Alcohol Withdrawal. How long has it been around? Some Strategies in Diagnosis and Treatment Alcohol Withdrawal Some Strategies in Diagnosis and Treatment Historical and cultural aspects of man's relationship with addictive drugs With the colonial era, industrial revolution, and international

More information

Objectives. Objectives 9/11/2012. Chapter 18 Substance Abuse and Behavioral Emergencies. Identify four conditions that may mimic alcohol intoxication

Objectives. Objectives 9/11/2012. Chapter 18 Substance Abuse and Behavioral Emergencies. Identify four conditions that may mimic alcohol intoxication Chapter 18 and Objectives Identify four conditions that may mimic alcohol intoxication Describe alcohol withdrawal syndrome Identify five major classes of abused drugs Describe the care given to patients

More information

ALCOHOL CARE PROVISION 2013

ALCOHOL CARE PROVISION 2013 . In 2013 NHS Health Scotland on behalf of the Scottish Government commissioned research by Iconic Consultants. The aim of the research was to assess the availability, demand, utilization and capacity

More information

Alcohol and Sensible Drinking

Alcohol and Sensible Drinking Page 1 of 5 Alcohol and Sensible Drinking See your doctor or practice nurse if you are drinking above the safe limits and are finding it difficult to cut down. What are the recommended safe limits of alcohol

More information

Management and Treatment Guidelines For Acute Alcohol Withdrawal Policy

Management and Treatment Guidelines For Acute Alcohol Withdrawal Policy Management and Treatment Guidelines For Acute Alcohol Withdrawal Policy 2014 1 Title Management and Treatment Guidelines for Acute Alcohol Withdrawal Policy Reference Number Acute10/001 Original Implementation

More information

Clinical Guideline. Change History Date Change details, since approval Approved by

Clinical Guideline. Change History Date Change details, since approval Approved by Clinical Guideline 1. The detection of alcohol misusers attending hospital 2. The management of alcohol withdrawal syndrome (AWS) 3. The management of Wernicke s Encephalopathy (WE) Document Detail Document

More information

Alcohol treatment Information for service users Page

Alcohol treatment Information for service users Page South London and Maudsley NHS Foundation Trust Alcohol treatment Information for service users Page This leaflet tells you what you can expect during treatment for problems related to using alcohol. It's

More information

Alcohol Abuse and Addiction Management Protocol

Alcohol Abuse and Addiction Management Protocol Alcohol Abuse and Addiction Management Protocol All Team Members: Patient Self-Management Education and Support Alcohol is the most commonly abused drug in the United States. About 18 million people in

More information

Background. Population/Intervention(s)/Comparison/Outcome(s) (PICO) List of the systematic reviews identified by the search process

Background. Population/Intervention(s)/Comparison/Outcome(s) (PICO) List of the systematic reviews identified by the search process updated 2012 Treatment of alcohol withdrawal delirium Q3: In the treatment of alcohol withdrawal delirium, are benzodiazepines or antipsychotics safe and effective when compared to a placebo/appropriate

More information

Emergencies Related to ETHANOL (ETOH) Alcohol

Emergencies Related to ETHANOL (ETOH) Alcohol University of Wisconsin Hospital and Clinics Emergency Education Center Emergencies Related to ETHANOL (ETOH) Alcohol Alcoholics are in all socio-economical levels of society ~ETOH is one of the most commonly

More information

NHS FORTH VALLEY. Guidance on Alcohol Dependence: Hospital Management of Alcohol Withdrawal (Emergency Department and in-patient setting)

NHS FORTH VALLEY. Guidance on Alcohol Dependence: Hospital Management of Alcohol Withdrawal (Emergency Department and in-patient setting) NHS FORTH VALLEY Guidance on Alcohol Dependence: Hospital Management of Alcohol Withdrawal (Emergency Department and in-patient setting) Approved 09/04/2015 Version 4.2 Date of First Issue July 2002 Review

More information

Trust Guideline for the Management of: Acute Alcohol withdrawal (excluding pregnancy)

Trust Guideline for the Management of: Acute Alcohol withdrawal (excluding pregnancy) A clinical guideline recommended for use In: By: For: Key words: Written by: Supported by: Medical and Surgical Wards All Medical Staff Adult Alcohol dependent patients Alcohol, Withdrawal, Detoxification

More information

SUBSTANCE ABUSE SCREENING

SUBSTANCE ABUSE SCREENING OVERVIEW Substance abuse in the elderly is a common problem that is frequently under- diagnosed by primary care doctors and families. Alcohol abuse is present in 10% to 15% of elderly individuals who seek

More information

Alcohol withdrawal. Clinical features

Alcohol withdrawal. Clinical features Alcohol withdrawal Clinical features Severity increase with amount consumed; uncommon with < drinks per day. Predictable pattern: patients with previous withdrawal seizures are at high risk for recurrence.

More information

NHS Fife Guidance for the Identification, Assessment and Management of Harmful Drinking and Alcohol Dependence

NHS Fife Guidance for the Identification, Assessment and Management of Harmful Drinking and Alcohol Dependence NHS Fife Guidance for the Identification, Assessment and Management of Harmful Drinking and Alcohol Dependence Staff working in services provided and funded by the NHS who care for people who potentially

More information

Alcohol management York Service Alcohol management - medically assisted alcohol withdrawal and supported reduction

Alcohol management York Service Alcohol management - medically assisted alcohol withdrawal and supported reduction Alcohol management York Service Alcohol management - medically assisted alcohol withdrawal and supported reduction Version 4 JT January 2014 page 1 Alcohol Management York Service assessment of alcohol

More information

Alcohol Addiction. Introduction. Overview and Facts. Symptoms

Alcohol Addiction. Introduction. Overview and Facts. Symptoms Alcohol Addiction Alcohol Addiction Introduction Alcohol is a drug. It is classed as a depressant, meaning that it slows down vital functions -resulting in slurred speech, unsteady movement, disturbed

More information

Alcohol Related Liver Disease

Alcohol Related Liver Disease Alcohol Related Liver Disease Nonalcoholic Fatty Liver Disease (NAFLD) 1 Why is the liver important? Your liver is a vital organ that performs many essential functions. It filters out harmful substances

More information

Symptom-Triggered Alcohol Detoxification in C&V UHB Hospitals - Guideline

Symptom-Triggered Alcohol Detoxification in C&V UHB Hospitals - Guideline Reference Number: UHB 202 Version Number: 2 Date of Next Review: 19 th February 2019 Previous Trust/LHB Reference Number: N/A Symptom-Triggered Alcohol Detoxification in C&V UHB Hospitals - Guideline Introduction

More information

Alcohol related ataxia. Information for patients Neurology

Alcohol related ataxia. Information for patients Neurology Alcohol related ataxia Information for patients Neurology page 2 of 8 What is ataxia? Ataxia means lack of co-ordination, and is the result of damage to a part of the brain called the cerebellum which

More information