Treating the "unhealthy alcohol user" on medical wards: beyond withdrawal.J Psychiatr Pract 2013; 19(3):213-26JP
Alcohol use disorders (AUDs) are common among patients admitted to general hospitals. Unfortunately, AUDs often go undetected and untreated. Psychiatrists are frequently called upon to assist in the management of cases involving alcohol withdrawal. However, there is a dearth of knowledge regarding potential therapeutic approaches to AUDs beyond the acute withdrawal stage.
This article presents an overview of the epidemiology, clinical characteristics, and treatment of AUDs on medical wards, with a specific focus on the post alcohol-withdrawal phase.
This article is based on a survey of the published literature on AUDs and their treatment in the medical ward using the PubMed database.
Various screening tools are available to facilitate the detection of AUDs. Among non-medically ill patients, brief psychological interventions have proven to be effective in primary care and emergency room settings, while pharmacotherapy has been shown to reduce the risk of relapse. Existing data on the implementation of these interventions in the general hospital setting remain scarce.
Current evidence suggests the need for additional research in this area with a view toward clarifying AUD treatment guidelines for medically ill inpatients. The hospital stay could provide a valuable opportunity to initiate interventions for AUDs with medically ill patients, leading to significant changes in alcohol use behaviors and better health-related outcomes.