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Alcohol - problem drinking - Management
Basis for recommendation
These recommendations are based on the clinical guidelines Alcohol-use disorders: diagnosis and clinical management of alcohol-related physical complications, published by the National Institute for Health and Clinical Excellence (NICE) [NICE, 2010a], and are consistent with guidelines published by the National Treatment Agency for Substance Misuse [Raistrick et al, 2006] and the Scottish Intercollegiate Guidelines Network (SIGN) [SIGN, 2003].
- People who drink harmful amounts of alcohol are often malnourished and deficient in vitamins. In particular, thiamine deficiency is common due to poor diet, poor absorption of nutrients (caused by gastritis), and a high demand for the vitamin (it is a coenzyme in alcohol metabolism).
- Lower doses of oral thiamine (10–25 mg) are recommended for harmful drinkers who may have mild chronic deficiency [BNF 59, 2010]. However, as tablets are most readily available at a dose of 50 mg, and it is very unlikely thiamine will cause harm at higher doses, CKS recommends that 50 mg should be taken daily.
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