Alcohol- Alcohol withdrawal management
- Critria for home detoxification
- Criteria for hospital detoxification
- Alcohol publications
Northumberland alcohol resource
file
- Alcohol withdrawal contract with patient
- Chlordiazepoxide withdrawal schedule
- Chlordiazepoxide withdrawal patient advice leaflet
- Diazepam withdrawal schedule
- Diazepam withdrawal patient advice leaflet
Alcohol: Detection
Alcohol quantities
- Male > 21 units per week
- Female > 14 units per week
"CAGE" questioning
|
More than 2 positive responses = PROBLEM DRINKER
Biochemical tests
- MCV (mean corpuscular volume) > 92 fl.
- GGT (gamma-glutanyl transpeptidase) > 40 iu/l.
Both elevated identifies 3 in 4 PROBLEM DRINKERS
Other tests
- Serum urate > 360 umol/l
- Triglyceride level > 2 mmol/l
Alcohol withdrawal management
- Agree set goals - see Alcohol withdrawal contract with patient
- Change lifestyle
- Involve spouse
Drugs
- Alcohol: Drug withdrawal schedules
- Benzodiazepines
- Vitamins
- Anticonvulsents
- Antabuse
Referral
- Alcohol: Contact telephone numbers
- Alcohol treatment unit
- Alcoholics Anonymous
- Local council on alcoholism
- Hostels
- Psychiatric input
Criteria for home detoxification
- Desire by patient to dry out at home
- Adequate home support
- Previous absence of severe withdrawal symptoms
- Patient responsible with drugs - see Alcohol withdrawal contract with patient
- No severe mental illness or ill-health
Criteria for hospital detoxification
- Dehydration
- Liver disorders
- Cardiac problems
- Convulsions
- Malnutrition
- Acute infection
- Severe lung disease (benzodiazepine-induced respiratory depression)
- Severe depression
- Suicide risk
- Confusion
- Memory impairment
- Hallucinations
Alcohol: Drug withdrawal schedules
| Day 1 | 80mg | (20/20/20/20) |
| Day 2 | 80mg | (20/20/20/20) |
| Day 3 | 70mg | (20/10/20/20) |
| Day 4 | 50mg | (10/10/10/20) |
| Day 5 | 35mg | (10/5/5/15) |
| Day 6 | 25mg | (5/5/5/10) |
| Day 7 | 10mg | (5/0/0/5) |
Chlordiazepoxide withdrawal patient advice leaflet
| Day 1 | 40mg | (10/10/10/10) |
| Day 2 | 30mg | (10/0/10/10) |
| Day 3 | 25mg | (10/0/5/10) |
| Day 4 | 20mg | (5/0/5/10) |
| Day 5 | 15mg | (5/0/5/5) |
| Day 6 | 10mg | (5/0/0/5) |
| Day 7 | 5mg | (0/0/0/5) |
Diazepam withdrawal patient advice leaflet
Alcohol Use Disorders Identification Test - A World
Health Organisation document - page 31 has the identification tool.
Alcohol: Contact telephone numbers
- AA (7pm-10pm) 0191 261 8777
- Al-Anon Family Groups (24hr helpline) 0171 403 0888
- NE Council on Addictions 0191 234 3468
Alcohol publications
National
- Choosing Health Summary of Intelligence on Alcohol Department of Health (Nov 2004) www.dh.gov.uk
- Choosing Health White Paper Department of Health (Nov 2004) www.dh.gov.uk
- Drinking Responsibly the Governments Proposals, Department for Culture Media and Sport, Home Office, Office of the Deputy Prime Minister (Jan 2005) www.homeoffice.gov.uk
- Prevention of alcohol misuse Health Development Agency (Dec 2004) www.nice.org.uk
- Prevention and reduction of alcohol misuse Evidence briefing 2nd edition Health Development Agency (March 2005) www.nice.org.uk
- Alcohol Harm Reduction Strategy for England Executive Summary Prime Minister’s Strategy Unit (March 2004) www.strategy.gov.uk
- Local Alcohol Strategy Toolkit London Drug and Alcohol Network and Alcohol Concern 2004 www.localalcoholstrategies.org.uk
Local
- Report of the Alcohol and young people working Group Northumberland County Council Overview and Scrutiny Committee (Dec 2004)