DRUG AND ALCOHOL

Drug and/or alcohol dependence is a difficult thing to treat. Whether you’re a seasoned professional or a an intern on their first ED shift - drug and alcohol presentations can be very challenging.

During business hours there are D&A workers who are available to assess people who present with substance misuse/dependence and are seeking help with behaviour change. Staffing of this service is a bit haphazard at times. The mental health “Adult Pack” contains numbers for drug and alcohol services in the local area.

In Hours D+A nurse available on 0438221538

ALCOHOL WITHDRAWAL toolbox

For alcohol dependent patients admitted for withdrawal or any other reason:

1. Diazepam -

   • Be aware of high risk patients (e.g. previous delirium tremens or withdrawal seizures, frail/elderly pts)

     • NEED TO FRONT LOAD DIAZEPAM IF BEING ADMITTEED

     • 10-20mg every 2 hours for 3 doses if mentation and respiratory status permits

       • THEN as per AWS

2. Alcohol level

3. LFTs, Coagulation profile, B12, folate and iron studies if for admission

4. Thiamine -

   • Wernicke’s encephalopathy 500mg IV and 300mg IV TDS

   • High risk patients 300mg IV or IM and 100mg IV TDS

   • All other patients 100mg IV or IM and 100mg TDS PO or IV