ALCOHOL: ACUTE WITHDRAWAL
Alcohol, a CNS depressant drug, is used socially in our society for many reasons: to enhance the flavor of food, to
encourage relaxation and conviviality, for celebrations, and as a sacred ritual in some religious ceremonies.
Therapeutically, it is the major ingredient in many OTC/prescription medications. It can be harmless, enjoyable, and
sometimes beneficial when used responsibly and in moderation. Like other mind-altering drugs, however, it has the
potential for abuse, and, in fact, is the most widely abused drug in the United States (research suggests 5%–10% of the
adult population) and is potentially fatal.
May be inpatient on a behavioral unit or outpatient in community programs. Although patients are not generally
admitted to the acute care setting with this diagnosis, withdrawal from alcohol may occur secondarily during
hospitalization for other illnesses/conditions. A short hospital stay may be required during the acute phase because of
severity of general condition, or a delayed discharge from acute care can be the result of alcohol withdrawal beginning
within 6–48 hr of admission.
Cirrhosis of the liver
Upper gastrointestinal/esophageal bleeding
Psychosocial aspects of care
Substance dependence/abuse rehabilitation
PATIENT ASSESSMENT DATABASE
Data depend on the duration/extent of use of alcohol, concurrent use of other drugs, degree of organ involvement, and
presence of other pathology.
Difficulty sleeping, not feeling well rested
Generalized tissue edema (due to protein deficiencies)
Peripheral pulses weak, irregular, or rapid
Hypertension common in early withdrawal stage but may become labile/progress to
Tachycardia common during acute withdrawal; numerous dysrhythmias may be identified
Feelings of guilt/shame; defensiveness about drinking
Multiple stressors/losses (relationships, employment, finances)
Use of alcohol to deal with life stressors, boredom
Bowel sounds varied (may reflect gastric complications, e.g., hemorrhage)
Nausea/vomiting; food intolerance
Gastric distension; ascites, liver enlargement (seen in cirrhosis)