In this week’s pearl we will discuss how to identify patients at risk for alcohol withdrawal syndrome (AWS)
Introduction
Chronic alcohol use results in downregulation of the inhiitory system (GABA) and upregulation of excitatory system (Norepinephrine)
When a patient stops drinking alcohol there is a GABA deficiency and increase in norepinephrine which results in increased symptahtetic autonomic activity
How to Identify Patients at Risk for Alcohol Withdrawal Syndrome
Audit-C
Rule of 4
AUDIT-PC
Consists of 5 questions from the full 10 question AUDIT
Score of 4 or more could indicate that the patient is at risk for AWS
Rule of 4
4 or more standard drinks per day for 4 or more weeks
Standard Drink Reference
References
UK Health Security Agency. "Alcohol Use Disorders Identification Test for Primary Care (AUDIT-PC)." GOV.UK, 2022, assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1113176/Alcohol-use-disorders-identification-test-for-primary-care-AUDIT-PC_for-print.pdf.
Williams, P., Brigham, S., & Watto, M. (Hosts). (n.d.). #2 Get in the spirit of ambulatory alcohol withdrawal [Audio podcast episode]. In The Curbsiders Addiction Medicine Podcast. The Curbsiders. https://thecurbsiders.com/addiction-medicine-podcast/2-get-in-the-spirit-of-ambulatory-alcohol-withdrawal
Centers for Disease Control and Prevention. (2024, May 15). Standard drink sizes. U.S. Department of Health and Human Services. https://www.cdc.gov/alcohol/standard-drink-sizes/index.html