Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-22T20:47:37.310Z Has data issue: false hasContentIssue false

Chapter 8 - Alcohol Misuse

Published online by Cambridge University Press:  04 January 2024

By
Rachel Thomasson  and
Ashokkumar Shishodia
Edited by
Rachel Thomasson ,
Elspeth Guthrie  and
Allan House
Rachel Thomasson
Affiliation:
Manchester Centre for Clinical Neurosciences
Elspeth Guthrie
Affiliation:
Leeds Institute of Health Sciences
Allan House
Affiliation:
Leeds Institute of Health Sciences
Get access

Summary

Complications of alcohol misuse are frequently encountered in the general hospital setting, as well as primary care and outpatient clinics. It is an essential part of the skillset of a consultation-liaison (CL) psychiatrist to be able to competently assess the scale of the problem, to offer advice and guidance on acute issues which may arise during intoxication and withdrawal and to orchestrate appropriate support and follow-up if a patient is willing to engage. This chapter aims to equip the reader with relevant epidemiology, some clinically useful biology and mathematics and a scaffold for building on previously acquired basics in terms of assessment and management of alcohol-related problems in the general hospital setting.

Keywords

alcoholalcoholismalcoholdependencealcohol intoxicationalcohol withdrawalalcohol detoxificationdelirium tremensWernicke’s encephalopathy
Type
Chapter
Information
Seminars in Consultation-Liaison Psychiatry , pp. 117 - 133
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization. Global status report on alcohol and health. Geneva; 2018. www.who.int/publications/i/item/9789241565639.Google Scholar
Office for National Statistics. Adult drinking habits in Great Britain: 2017. www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/datasets/adultdrinkinghabits.Google Scholar
Public Health England. Alcohol dependence prevalence in England. 2021. www.gov.uk/government/publications/alcohol-dependence-prevalence-in-england.Google Scholar
Public Health England. The public health burden of alcohol: Evidence review. 2018. www.gov.uk/government/publications/the-public-health-burden-of-alcohol-evidence-review.Google Scholar
Scottish Government Cabinet Secretary for Health and Social Care. Scottish Health Survey 2018 – revised 2020: volume one – main report. Chapter 3 – Alcohol. 2020. www.gov.scot/publications/scottish-health-survey-2018-volume-1-main-report/pages/30.Google Scholar
Public Health England. Adult substance misuse treatment statistics 2018 to 2019: Report. 2023. www.gov.uk/government/collections/alcohol-and-drug-misuse-and-treatment-statistics.Google Scholar
NHS Digital. Health Survey for England, 2018: Adults’ health related behaviours report. 2019. https://files.digital.nhs.uk/B5/771AC5/HSE18-Adult-Health-Related-Behaviours-rep-v3.pdf.Google Scholar
Office for National Statistics. Alcohol specific deaths in the UK registered 2020. 2021. www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/alcoholrelateddeathsintheunitedkingdom/registeredin2020.Google Scholar
Thomasson, R. The apparently drunk patient. In Mackway-Jones, K (ed.), Acute Psychiatric Emergencies. New York; 2020, pp. 37–50.Google Scholar
Mirijello, A, D’Angelo, C, Ferrulli, A et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2006;75(4):353–65.Google Scholar
Saunders, JB. The alcohol use disorders identification test. https://auditscreen.org.Google Scholar
Stockwell, T, Murphy, D, Hodgson, R. The severity of alcohol dependence questionnaire: Its use, reliability and validity. Br J Addict. 1983;78(2):145–55. www.mdapp.co/severity-of-alcohol-dependence-questionnaire-sadq-calculator–518.CrossRefGoogle ScholarPubMed
International Statistical Classification of Diseases and Related Health Problems, 11th ed.; ICD-11; World Health Organization. Geneva; 2019.Google Scholar
Strategies for managing alcohol withdrawal. In Fishman, MJ, Shulman, GR, Mee-Lee, D (eds.), ASAM Patient Placement Criteria: Supplement on Pharmacotherapies for Alcohol Use Disorders. Philadelphia, PA; 2010, p. 32.Google Scholar
National Institute for Health and Care Excellence. Head injury: Assessment and early management. 2019. www.nice.org.uk/guidance/cg176.Google Scholar
Psychiatric emergencies. In Ramrakha, P, Moore, K, Sam, S (eds.), Oxford Handbook of Acute Medicine, 4th ed. Oxford; 2019, pp. 711–38.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA; 2013.Google Scholar
Sullivan, JT, Sykora, K, Schneiderman, J et al. Assessment of alcohol withdrawal: The revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict. 1989;84(11):1353–7.CrossRefGoogle ScholarPubMed
Maldonado, JR, Sher, Y, Das, S et al. Prospective Validation Study of the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) in medically ill inpatients: A new scale for the prediction of complicated alcohol withdrawal syndrome. Alcohol. 2015;50(5):509–18.Google ScholarPubMed
Mayo-Smith, MF, Beecher, LH, Fischer, TL et al. Management of alcohol withdrawal delirium: An evidence-based practice guideline. Arch Intern Med. 2004;164(13):1405–12.CrossRefGoogle ScholarPubMed
Bird, RD, Makela, EH. Alcohol withdrawal: What is the benzodiazepine of choice? Ann Pharmacother. 1994;28(1):67–71.CrossRefGoogle ScholarPubMed
Muzyk, AJ, Leung, JG, Nelson, S et al. The role of diazepam loading for the treatment of alcohol withdrawal syndrome in hospitalized patients. Am J Addict. 2013;22:113–18.CrossRefGoogle ScholarPubMed
Jaeger, TM, Lohr, RH, Pankratz, VS. Symptom-triggered therapy for alcohol withdrawal syndrome in medical inpatients. Mayo Clin Proc. 2001;76(7):695–701. doi: 10.4065/76.7.695.CrossRefGoogle ScholarPubMed
Public Health Scotland. Alcohol brief interventions (ABI) training manual part 1. 2011. www.healthscotland.com/uploads/documents/16720-ABI_TrainingManualPart1.pdf.Google Scholar
Public Health Scotland. Alcohol brief interventions (ABI) training manual part 2. 2011. www.healthscotland.com/uploads/documents/16720-ABI_TrainingManualPart2.pdf.Google Scholar
Public Health England. Adult substance misuse treatment statistics 2018 to 2019: Report. 2023. www.gov.uk/government/collections/alcohol-and-drug-misuse-and-treatment-statistics.Google Scholar
Miller, WR, Sanchez, VC. Motivating young adults for treatment and lifestyle change. In Howard, G (ed.), Issues in Alcohol Use and Misuse by Young Adults. Notre Dame, IN; 1993, pp. 55–82.Google Scholar
Davey, CJ, Landy, MS, Pecora, A. et al. A realist review of brief interventions for alcohol misuse delivered in emergency departments. Syst Rev. 2015;4:45.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×