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April is Alcohol Awareness Month, according to the National Council on Alcoholism and Drug Dependence (NCADD).

How do we care for our patients who struggle with addiction? What can we do to make sure they receive the best possible care?

Thank you for all the care and support you give to our patients, especially those who are battling with addiction. And if you yourself are struggling with addiction, please reach out for help. You are not alone.

www.drughelpline.org

1-888-633-3239

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Understanding Addiction

"Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs.

Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover."

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A relatively new practice came to all the units at Mercy; SBIRT (Screening, Brief Intervention, & Referral to Treatment) screening in Epic, as a part of all admissions.

For those of you who don't know yet, the SBIRT program has been used in the Mercy ED for years, and there are people working who are incredible resources available for our patients!

The questions live in the admission database in Epic. If your patient shows a need for referral, it will automatically pop up as an order for referral. The SBIRT support coach will then follow up with the patient.

Pic of questions
Pic of referral pop up
SBIRT #
SBIRT Email

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What does an alcoholic patient look like?

You may see someone who is/has:

-highly nervous
-easily excited
-facial erythema
-repeat hospitalizations for injuries
-nausea/vomiting
-dyspepsia/reflux
-vague abdominal pain
-anorexia
-hypertension
-arrythmias
-palpitations/tachycardia

Labs: LFTs & Lytes
---hypomagnesmia
---hypokalemia
---hypophosphatemia
---AST:ALT ratio > 1:1

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Follow the  blocks on this page to learn some basics about the topic.

Read this page in blocks - top to bottom, left to right.

Pink text includes a link to more information.

You can leave a comment, or respond to a comment, on any section! Please be mindful not to share any patient-specific information here!

The last block on the right is a case study - take a look and test your knowledge!

After you finish the case study, be sure to post a comment under it, with your name, to be entered for a chance to win a prize for the month! The prize drawing will take place on 4/30, but the education will always remain active if you would like to revisit at a later time.

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Hypoglycemia
Malnutrition

Thiamine Deficiency

Folate Deficiency
Hallucinations
Seizures
Delirium Tremens

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Usually occurs within 12-24 hours after the patient's last drink.

Signs/Symptoms:

--tachycardia
--elevated BP
--tremors
--hyperreflexia
--increased irritability

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Treatment: WHAT do we do? And WHY do we do it?

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Treatment: WHAT do we do? And WHY do we do it?

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Thiamine
Folate
IV Fluids
Cardiac Monitoring
Benzodiazepines
Vital Sign Monitoring
Intake and Output Monitoring
Fall Precautions
Aspiration Precautions

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(valium, ativan, librium, serax)

Side Effects: