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Face Addiction
Published in Sandra Rasmussen, Developing Competencies for Recovery, 2023
Granted, hospital-based and residential programs have many benefits. Alcohol detoxification may require medical treatment in the case of delirium tremens, a life-threatening alcohol withdrawal syndrome that occurs with heavy or long-term drinking. Some drugs, such as benzodiazepines, must be tapered slowly. Longer treatment programs provide patients with extended time to address factors that contributed to addiction. Relapse prevention is a major goal of longer treatment.
Benzodiazepines: Anticonvulsant and other clinical uses
Published in Adam Doble, Ian L Martin, David Nutt, Calming the Brain: Benzodiazepines and related drugs from laboratory to clinic, 2020
Adam Doble, Ian L Martin, David Nutt
A further use of benzodiazepines is in the treatment of alcohol withdrawal (Romach and Sellars, 1991). Indeed, although a variety of agents, including sedative neuroleptics, anti-convulsants such as carbamazepine, adrenergic drugs such as clonidine and sedatives such as clomethiazole and γ-hydroxybutyrate, have been used extensively in the management of acute alcohol detoxification, there is little empirical evidence for the clinical utility of any pharmacological treatments other than benzodiazepines. The American Society for Addiction Medicine sponsored an extensive survey of published clinical data on alcohol detoxification using an evidence-based medicine approach, and concluded that the benzodiazepines were the only drugs to have demonstrated unambiguous proof of efficacy in relieving the major symptoms of alcohol withdrawal (Mayo-Smith, 1997).
Pharmacological interventions
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Following the diagnosis of physical dependence, symptoms of alcohol withdrawal should be treated urgently. The choice of drug to support alcohol detoxification is benzodiazepines, usually chlordiazepoxide or diazepam. The aims are to improve completion rates of detoxification and reduction in the following cases: severity of the withdrawal syndrome;incidence of complications;adverse effects of medication.
Development of a lower-sodium oxybate formulation for the treatment of patients with narcolepsy and idiopathic hypersomnia
Published in Expert Opinion on Drug Discovery, 2022
Gunjan Junnarkar, Clark Allphin, Judi Profant, Teresa L. Steininger, Cuiping Chen, Katie Zomorodi, Roman Skowronski, Jed Black
In future studies, it will be important to determine whether transitioning from SXB to LXB lowers BP in the short term and reduces CV risk in the long term. Further research would be required to explore the relationship between the lower Cmax of oxybate following LXB administration and a potential lower incidence of nausea and vomiting compared with SXB. Recent clinical trial results in adults with idiopathic hypersomnia demonstrating a clinically meaningful effect of LXB on EDS, self-reported global change, and overall symptom severity of idiopathic hypersomnia indicate the potential of LXB to address further unmet needs where there are no approved therapies [57,78]. The long-term efficacy and safety profile of LXB in patients with idiopathic hypersomnia will be evaluated now that an open-label extension phase of the phase 3 idiopathic hypersomnia clinical trial has been completed as of December 2020. In addition to the approval of SXB and LXB in the US and European Union for treating narcolepsy, and the approval of LXB in the US for treating idiopathic hypersomnia, SXB has been approved in some European countries for treating alcohol withdrawal syndrome. SXB administration throughout the day reduces withdrawal symptoms (eg, tremor, sweating, anxiety, hallucinations, and seizures) during alcohol detoxification and also reduces cravings for alcohol [79]. The lower-sodium formulation of LXB may thus enhance the quality of life not just for people with narcolepsy and idiopathic hypersomnia, but also for those seeking treatment for alcohol addiction.
Domiciliary alcohol detoxification outcomes: a study from Goa, India
Published in Journal of Addictive Diseases, 2020
Saumitra Nemlekar, Pooja Gaonkar, Anil Rane
Alcohol is a significant public health problem in India. According to the national statistics nearly 4.7% of individuals have alcohol use disorder (AUD).1 There is a significant treatment gap of up to 86.3% for those suffering from alcohol use disorder.2 The pattern of drinking in India is characterized by relatively high abstention rates but high rates of AUD among those who do drink.3,4 For a densely populous nation with limited mental health resources5 treating these patients adequately is a challenge. Treatment of alcohol begins with detoxification, but in most cases is not a sufficient intervention to result in prolonged abstinence. Detoxification can be carried out in the community or inpatient facility, the decision is based on the severity of alcohol dependence.6 Evidence favors community detoxification use rather than indoor detoxification with respect to better overall outcome, cost-effectiveness, feasibility, treatment gap reduction and client acceptance with the former.6,7 Local guidelines for community detoxification are not available. Similarly literature is sparse about outcomes in naturalistic settings. Outcome data are only available from regions which have robust follow up facilities.8 The objective of this study was to appraise community detoxification in real world settings. Here, we present outcomes of 100 alcohol detoxification patients treated on domiciliary basis.
The alcohol detoxification protocol and creation of the e-consult at Central Texas Veterans health care system
Published in Baylor University Medical Center Proceedings, 2020
James A. Hall, John David Coppin, Arshad Ghauri, George Martinez
An alcohol detoxification protocol was developed to assess the need for admission for alcohol withdrawal and provide guidance pertaining to medication options as well as placement (Figure 1). The protocol includes the alcohol detox e-consult order option, which prompts an internal medicine physician to call the patient daily for 5 days to assess signs or symptoms of withdrawal, the patient’s ability to abstain from alcohol, compliance with the outpatient medication regimen (gabapentin/lorazepam, vitamins, and naltrexone), need for rescue medication, interest in substance abuse treatment programs/domiciliary/mental health, appropriate follow-up, and need for referral to the ED for further aid in management. The protocol and e-consult were created by the internal medicine and psychiatry departments at CTVHCS. Several educational avenues were utilized to disseminate the protocol and e-consult. Hospitalists were informed during a weekly meeting, and medical residents were educated during a morning report. The ED physicians and hospitalists received the protocol by email on several occasions, and the protocol was posted as a flyer in the ED as a reference.