Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

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Friday, November 2, 2007

Evidence Note 20 - Screening tools, detoxification and vitamin supplementation for alcohol dependence


Background

Alcohol misuse in Scotland is a significant problem and evidence shows that 27% of men and 14% of women are drinking more than the weekly recommended levels. The overall estimated cost to society is £1 billion per year. Alcohol dependence is defined as a cluster of physiological, behavioural and cognitive phenomena in which the use of alcohol assumes higher priority for an individual than other behaviours. The level of dependence can either be moderate or severe. The first step in helping people overcome their alcohol dependence is detoxification. Detoxification is deliberate alcohol withdrawal managed clinically in an inpatient or outpatient setting. This evidence note focuses on screening tools, detoxification, drugs and adjunctive vitamin supplementation for alcohol dependence. It provides the best available evidence from published secondary literature to inform planners and practitioners.


Key points

  • Appropriate screening tools for detecting people with alcohol dependence that may need detoxification are Fast Alcohol Screening Test (FAST) in A&E settings and Cut down Annoyed Guilty Eye-opener (CAGE) plus or FAST in community settings.
  • People with moderate alcohol dependence can be effectively and safely detoxified in community/home/outpatient settings. However, people with severe alcohol dependence will require care in an inpatient setting with close monitoring by specialists. Outpatient and home detoxification settings are clinically effective and less costly than inpatient settings.
  • Benzodiazepines are the best choice of drugs and chlordiazepoxide is preferred for treating uncomplicated detoxification due to its reduced potential for dependency.
  • High dose parenteral thiamine is an effective treatment for Wernicke’s encephalopathy.Vitamin supplements should be prescribed where nutritional deficiencies are likely.

Link opens in new windowEvidence Note 20 (PDF, 202KB, 29secs)

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