Will this patient go into severe alcohol withdrawal?

New research from the BC Centre on Substance Use (BCCSU) suggests applying easy and effective tool to identify patients at high risk of going into withdrawal, in efforts to modernize alcohol detox. In a study published in the August issue of the peer-reviewed Journal of American Medical Association, BCCSU researchers used data from approximately 71,295 persons taking part in 14 scientific studies to predict which patient will develop serious complications, including seizures and delirium.

Which patient will go into severe alcohol withdrawal?

From the press release by British Columbia Centre on Substance Use (Aug 28, 2018):

Research sheds light on how to improve diagnosis and treatment of severe alcohol withdrawal syndrome

The treatment of alcohol withdrawal urgently needs to be modernized in order to improve patient outcomes and safety and reduce health care cost, according to new research from the BC Centre on Substance Use (BCCSU).

The study, published today in the Journal of the American Medical Association, involved a multi-year systematic review involving more than 71,000 patients and sought to determine how best to identify the risks of developing severe, complicated alcohol withdrawal – a potentially life-threatening emergency. Those who consume alcohol in quantities above low-risk recommendations may develop this syndrome when they abruptly stop or substantially reduce their alcohol consumption.

Researchers found that patients are commonly over-admitted into inpatient alcohol withdrawal management care, resulting in a poor patient experience and unnecessary health care resource consumption. The review identified highly valid and easily administered screening tools to properly assess symptoms and risks before recommending acute treatment such as withdrawal management, and to look at outpatient care to improve patient outcomes and reduce the burden on the health system.

“Alcohol addiction is not only the most common substance use disorder, it’s among the most devastating in terms of both health impacts and the costs to our health system,” said Dr. Evan Wood, executive director of the BCCSU and lead author of the study. “This study demonstrates that there are more sophisticated tools that the health system should be employing to provide more appropriate care for patients, which will result not only in better outcomes but also free-up resources for high-priority needs.”

According to a study released by the University of Victoria’s Canadian Institute for Substance Use Research (CISUR) and the Canadian Centre on Substance Use and Addiction (CCSA), alcohol use costs Canadians $14.6 billion per year in health care, lost production, criminal justice, and other direct costs – higher than all other substances combined.

B.C. has the highest rate in the country of hospitalizations entirely caused by alcohol, and consumption is rising faster in the province than elsewhere in Canada. Research from the Canadian Institute for Health Information published last year found that British Columbians who use alcohol consume, on average, 9.4 litres of pure alcohol each year — the equivalent of roughly 14 bottles of beer or two-and-half bottles of wine each week.

“Hospital wards are often filled with individuals suffering the consequences alcohol addiction,” said Dr. Keith Ahamad, a co-author on the study and Medical Director at Vancouver Coastal Health’s Regional Addiction Program. “This study helps identify those who truly need admission and demonstrates that many patients can be better treated as outpatients, even in primary care.”

The BCCSU is funded by the provincial government and is currently developing provincial guidelines for treating alcohol use disorder, expected to be released later this. They will be the first evidence-based guidelines of their kind for the province.

(Text taken from http://www.bccsu.ca/news-releases/)

From: Will This Hospitalized Patient develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review. JAMA (In Press) JAMA Network: jama.jamanetwork.com

If you’re interested in alcohol, read more about my alcohol research here.

For more information about the study or to schedule an interview, please contact:
Kevin Hollett, BC Centre on Substance Use
778-918-1537
khollett[at]cfenet.ubc.ca