Eli5: What happens to alcohol dependent people, that need to stay in the hospital for a different reason like an infection or surgery, how do they prevent withdrawal symptoms?
In: Biology
Close observation of the patient to monitor for physiological signs of alcohol withdrawal, as they can have severe/life-threatening implications. The CIWA tool (clinical institute withdrawal assessment for alcohol) is commonly used for this, and example of which can be found [here](https://www.ewin.nhs.uk/sites/default/files/Appendix%206%20-%20CIWA%20-Ar%20Form%203250.pdf)
For those with moderate to severe withdrawal we will use drugs to help the physical come-down from the alcohol. The most common is called *chlordiazepoxide*, which can be given both as a *stat* dose (i.e. a there-and-then administration to help immediate effects of acute withdrawal) and as part of a *fixed-dose reducing regime* (a standard dosing regime that starts on at a level dependant on what the person’s alcohol dependence is, and then slowly reduces over a week or two to nothing).
It is important to note that addition and withdrawal – especially for alcohol, among others – is not just a physiological dependence. There is also the psychological and social aspects, which are not as simple to manage. For most larger UK/NHS hospitals there will be specialist staff who can help consult and advice on how to help safely manage withdrawal but even then it is not one-size-fits-all and not always successful.
For further reading on, consider guidance as follows: [https://bnf.nice.org.uk/treatment-summaries/alcohol-dependence/](https://bnf.nice.org.uk/treatment-summaries/alcohol-dependence/) (see also at the end links to further guidance documents on alcohol misuse)
There are drugs which help with withdrawal symptoms and the doctors may administer these. It is also possible to administer alcohol to prevent withdrawal, or at least dampen it. The alcohol may be administered intravenously and does not have to be the regular full dose that the patient usually have.
From a family member who works in a hospital, they stock bottles of port and sherry for alcoholics. Their doctor prescribes a tiny Dixie cup of port per day to stave off withdrawal symptoms
Someone i know got put into hospital for reasons. He was a heavy drinker, and to make sure the withdrawals didn’t finish him off they gave him 2 shots of vodka every day. At some point they ran out and they had to order more. In the meantime he got administered Cognac…
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