Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • withdrawal
  • tolerance
  • increased/decreased liver size, jaundice, ascites

Other diagnostic factors

  • nicotine dependence comorbidity
  • social, economic, legal, or psychological problems
  • nausea, vomiting, abdominal pain, haematemesis
  • muscle cramps, pain, tenderness, altered sensory perception
  • hypertension and tachycardia
  • impaired nutritional status
  • cutaneous manifestations
  • alterations in normal dental hygiene
  • broad-based gait

Risk factors

  • family history of alcoholism
  • antisocial behaviour (pre-morbid)
  • high trait anxiety level
  • lack of facial flushing on exposure to alcohol
  • low responsivity to the effects of alcohol
  • history of gastric bypass

Diagnostic investigations

1st investigations to order

  • diagnostic interview
  • alcohol level (breath and blood)
  • Clinical Institute Withdrawal Assessment for Alcohol--revised (CIWA-Ar)
Full details

Investigations to consider

  • carbohydrate-deficient transferrin (CDT)
  • gamma-GT, ALT, AST
  • FBC
  • urinary ethyl glucuronide
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Addiction Psychiatrist

Pittman Psychiatry and Recovery

Arlington

TX

Disclosures

JRP declares that she has no competing interests.

Addiction Psychiatrist

Medical Director, Opioid Treatment Program

VA Puget Sound Health Care System, American Lake Division

Tacoma

WA

Disclosures

PHC declares that he has no competing interests.

Dr Julie R. Pittman and Dr Philip H. Chung would like to gratefully acknowledge Dr Robert M. Swift and Dr Lorenzo Leggio, the previous contributors to this monograph. RMS declares that he has no competing interests. LL is an author of a reference cited in this monograph.

Peer reviewers VIEW ALL

Royal Prince Alfred Hospital and Discipline of Medicine

University of Sydney

Sydney

Australia

Disclosures

PSH is an author of a reference cited in this monograph.

Bernard B. Brodie Department of Neuroscience

University of Cagliari

Cagliari

Italy

Disclosures

RA is an author of a number of references cited in this monograph.

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