Essentials - Management of Withdrawal - Opioids, Alcohol and Benzodiazepines-Handout - Essentials - Management of Withdrawal-Alcohol, Benzodiazepines and Opioids

Handout - Essentials - Management of Withdrawal-Alcohol, Benzodiazepines and Opioids

Pdf Summary

The content of the document is a summary of a lecture on the management of withdrawal from alcohol, benzodiazepines, and opioids. The speaker, Anthony Dekker DO, covers various aspects of detoxification including the importance of supervised detoxification to prevent life-threatening complications. He emphasizes that detoxification is not substance abuse treatment and outlines the three phases of detoxification: evaluation, stabilization, and fostering the patient's entry into treatment.<br /><br />Dr. Dekker provides a brief history of the treatment of medical withdrawal, including criminalization, incarceration, and the use of detox tanks. He notes that alcoholism was accepted as a disease by the AMA in 1958 and discusses the social model of treatment.<br /><br />The ASAM Patient Placement Criteria for detoxification are described, including different levels of care based on factors such as acute intoxication or withdrawal potential, biomedical conditions, emotional or behavioral conditions, and readiness to change.<br /><br />The importance of matching patients to appropriate care is highlighted, with different levels of care outlined for detoxification in freestanding substance abuse treatment facilities. Exclusionary criteria and the need for 24-hour supervision, medical stability, and biopsychosocial stability are noted.<br /><br />Specific treatment approaches for alcohol withdrawal are discussed, including fixed-dose regimens and symptom-driven regimens. The use of the Clinical Institute Withdrawal Assessment (CIWA) scale to assess alcohol withdrawal symptoms is explained, along with the goal of a smooth, efficient clinical course and minimal agitation and discomfort.<br /><br />The assessment and treatment of opiate withdrawal are also covered, with an emphasis on the use of buprenorphine for withdrawal. The Clinical Opiate Withdrawal Scale (COWS) is introduced as a tool for assessing opiate withdrawal symptoms, and different withdrawal protocols are provided.<br /><br />Various medications and strategies for managing withdrawal symptoms, including the use of potentiators, are mentioned, along with the importance of individualized treatment based on clinical practice and patient needs.<br /><br />The document concludes with a question and answer section.

Keywords

management of withdrawal

alcohol withdrawal

benzodiazepine withdrawal

opioid withdrawal

supervised detoxification

substance abuse treatment

detoxification phases

ASAM Patient Placement Criteria

treatment approaches

withdrawal symptoms