Cargando…

Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital

BACKGROUND: Alcohol use disorder (AUD) is a major public health concern in South Africa (SA). Abrupt cessation or reduction of alcohol intake in chronic users can result in withdrawal symptoms. Benzodiazepines are the treatment of choice but need to be used cautiously in patients with a lifetime his...

Descripción completa

Detalles Bibliográficos
Autores principales: Muddapah, Creeshen P., Weich, Lize
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900294/
https://www.ncbi.nlm.nih.gov/pubmed/36756541
http://dx.doi.org/10.4102/sajpsychiatry.v29i0.1915
_version_ 1784882819286171648
author Muddapah, Creeshen P.
Weich, Lize
author_facet Muddapah, Creeshen P.
Weich, Lize
author_sort Muddapah, Creeshen P.
collection PubMed
description BACKGROUND: Alcohol use disorder (AUD) is a major public health concern in South Africa (SA). Abrupt cessation or reduction of alcohol intake in chronic users can result in withdrawal symptoms. Benzodiazepines are the treatment of choice but need to be used cautiously in patients with a lifetime history of substance abuse given their highly addictive potential. Symptom-triggered prescription of benzodiazepines during alcohol withdrawal using the Revised Clinical Institute Withdrawal for Alcohol Scale (CIWA-Ar) has been associated with improved safety and reduced benzodiazepines use. AIM: To investigate if implementation of the CIWA-Ar during alcohol detoxification impacted the dose of benzodiazepines used and withdrawal-related outcomes. SETTING: Alcohol rehabilitation unit (ARU) at Stikland Psychiatric Hospital. METHODS: A retrospective cohort study of 135 admissions over a six-month period comparing two groups: before (2015) and after (2017) the implementation of the CIWA-Ar. RESULTS: The study noted no differences in sociodemographic and alcohol-associated variables between the two groups, and there were no recorded complications in either group. The 2017 group had a lower percentage of patients that required benzodiazepines (33.8% vs. 51.4%, p = 0.04) and a lower median total amount of benzodiazepines used during alcohol withdrawal (0 mg vs. 5 mg, p = 0.01). CONCLUSIONS: The CIWA-Ar rating scale was an effective alternative to prescribing benzodiazepines pro re nata and decreased the total dose of benzodiazepines used during alcohol withdrawal. CONTRIBUTION: The use of a symptom triggered regime, like the CIWA-Ar rating scale, during withdrawal can be implemented safely in a SA treatment setting for patients with low-risk AUD.
format Online
Article
Text
id pubmed-9900294
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher AOSIS
record_format MEDLINE/PubMed
spelling pubmed-99002942023-02-07 Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital Muddapah, Creeshen P. Weich, Lize S Afr J Psychiatr Original Research BACKGROUND: Alcohol use disorder (AUD) is a major public health concern in South Africa (SA). Abrupt cessation or reduction of alcohol intake in chronic users can result in withdrawal symptoms. Benzodiazepines are the treatment of choice but need to be used cautiously in patients with a lifetime history of substance abuse given their highly addictive potential. Symptom-triggered prescription of benzodiazepines during alcohol withdrawal using the Revised Clinical Institute Withdrawal for Alcohol Scale (CIWA-Ar) has been associated with improved safety and reduced benzodiazepines use. AIM: To investigate if implementation of the CIWA-Ar during alcohol detoxification impacted the dose of benzodiazepines used and withdrawal-related outcomes. SETTING: Alcohol rehabilitation unit (ARU) at Stikland Psychiatric Hospital. METHODS: A retrospective cohort study of 135 admissions over a six-month period comparing two groups: before (2015) and after (2017) the implementation of the CIWA-Ar. RESULTS: The study noted no differences in sociodemographic and alcohol-associated variables between the two groups, and there were no recorded complications in either group. The 2017 group had a lower percentage of patients that required benzodiazepines (33.8% vs. 51.4%, p = 0.04) and a lower median total amount of benzodiazepines used during alcohol withdrawal (0 mg vs. 5 mg, p = 0.01). CONCLUSIONS: The CIWA-Ar rating scale was an effective alternative to prescribing benzodiazepines pro re nata and decreased the total dose of benzodiazepines used during alcohol withdrawal. CONTRIBUTION: The use of a symptom triggered regime, like the CIWA-Ar rating scale, during withdrawal can be implemented safely in a SA treatment setting for patients with low-risk AUD. AOSIS 2023-01-31 /pmc/articles/PMC9900294/ /pubmed/36756541 http://dx.doi.org/10.4102/sajpsychiatry.v29i0.1915 Text en © 2023. The Authors https://creativecommons.org/licenses/by/4.0/Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Muddapah, Creeshen P.
Weich, Lize
Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title_full Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title_fullStr Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title_full_unstemmed Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title_short Assessing the revised Clinical Institute Withdrawal for Alcohol Scale use at Stikland Hospital
title_sort assessing the revised clinical institute withdrawal for alcohol scale use at stikland hospital
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900294/
https://www.ncbi.nlm.nih.gov/pubmed/36756541
http://dx.doi.org/10.4102/sajpsychiatry.v29i0.1915
work_keys_str_mv AT muddapahcreeshenp assessingtherevisedclinicalinstitutewithdrawalforalcoholscaleuseatstiklandhospital
AT weichlize assessingtherevisedclinicalinstitutewithdrawalforalcoholscaleuseatstiklandhospital