Alcohol Liaison Service. Alcohol Withdrawal. Information

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1 Alcohol Liaison Service Alcohol Withdrawal Information

2 Alcohol withdrawal If you are dependent on alcohol and suddenly stop drinking, there are a series of symptoms that you may experience. These include: Tremors or shaking Sweating Nausea / vomiting / diarrhoea Irritability / anxiety / panic Hallucinations (seeing, hearing or feeling things which are not there) Confusion Fits While it varies from person to person, the symptoms usually occur within 4-12 hours of your last alcoholic drink and are often at their most severe within hours. To get a better picture of any medical problem, various things need to be considered together. 2

3 These might include the severity of any physical symptoms, how long you have had your illness, your age, the influence of any medication and your lifestyle as well as the results of supporting tests that have been performed. Treatment Acute alcohol withdrawal is usually treated with 2 types of medication to prevent physical and mental health deterioration. Medication is not always necessary in alcohol detoxification and is dependent on your withdrawal symptoms and the severity of your alcohol use. 1) Benzodiazepines are the recommended drugs for detoxification. Benzodiazepines work slowly and therefore are less likely to lead to abuse. A reducing dose of chlordiazepoxide over 5-7 days is commonly used. Dose depends on factors including level of alcohol dependence, sex, weight, and current liver function. 3

4 Smaller doses may be needed for mild dependence and larger doses for severe dependence. People at high risk of seizures or delirium tremens may need a longer period of treatment (maximum of two weeks). Patients should not drive whilst undergoing benzodiazepine detoxification 2) Thiamine deficiency is common in people who misuse alcohol as their diet is usually poor and they become malnourished. Stomach irritation secondary to regular alcohol consumption can lead to further impaired absorption of vitamins. Thiamine deficiency can the brain to be deprived of glucose causing lesions on the brain. This is called Wernicke's Encephalopathy. If this is left untreated, Wernicke s Encephalopathy can lead to a form of irreversible brain damage called Korsakoff s syndrome Oral thiamine is poorly absorbed in dependent drinkers. 4

5 For this reason, all those undergoing detoxification within hospital or monitored community environments, are given high potency B complex vitamins (Pabrinex ) intravenously and will consist of two pairs of ampoules - three times a day for at least three days. If a patient is healthy and well-nourished and their alcohol withdrawal is uncomplicated then oral doses of Thiamine and Vitamin B Compound Strong may be considered in divided doses. Ongoing prescription of thiamine and vitamin B compound strong will be provided for continued use on discharge to prevent chronic deficiency in the future. Discharge and Follow up When discharged from hospital, involvement of the patient's GP is encouraged for monitoring and support of the treatment plan. Medication can be used once a patient is alcohol-free to help prevention of relapse and can be discussed as part of your treatment plan either within the hospital or community. 5

6 Counseling and support before and/or after detoxification is essential for patients to maintain their abstinence from alcohol and to prevent future relapse. All services are free and confidential and contact details can be found on page 7. 6

7 Contact Information Please see list of contacts for further information, advice or support The Alcohol Liaison Nurse Service Monday to Friday 9am - 5pm Help with drinking All services are free and confidential Substance 2 Solutions (CRI) Rutland and Leicestershire Swanswell Charity: Drinkline the national alcohol helpline available 24hrs/day

8 If you need this information in another format or language, please telephone Further information about the Trust is available on the following websites: KGH - NHS Choices - Ref: PI.721 April 2014 Review: January 2016