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Alcohol - problem drinking - Management
How should I assist withdrawal in primary care?

  • Give practical advice and support on how to cope with alcohol withdrawal, including a discussion of the following:
    • The symptoms that should be anticipated. These are most commonly depression, feeling nervous or anxious, and having difficulty sleeping for a few nights. Other common symptoms may include fatigue, craving for alcohol, restlessness, confusion, sweating, and muscular weakness.
    • Identifying a relative or friend who can provide support.
    • Practical issues, including travel arrangements, time off work, and provision of childcare.
    • Maintaining adequate hydration and eating normally as soon as possible.
    • Planning daily activities during and after detoxification to relieve stress and boredom.
  • Once assisted withdrawal has been decided as being in the best interests of the person and advice has been given:
    • Treat the person with a benzodiazepine — use a front-loading dose, and taper the dose over the course of 5–7 days.
    • A regimen consisting of a tapering dose of chlordiazepoxide is usually recommended, with daily monitoring where possible. Diazepam is another option. See the section on Benzodiazepines in Prescribing information.
  • At all stages of withdrawal, seek advice from an appropriate specialist if complications develop, or consider admission or referral.

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