Health care

Clinical sociology of Alcohol

8/14/2019 RAWAT 0 Comments


The withdrawal syndrome (definition of the DSM-4 classification [ 6 ] ) is defined by stopping or reducing alcohol consumption that was high and prolonged, two or more of the following criteria occurring within a few hours to a few days after criterion 


1: autonomic hyperactivity, tremor of extremities, insomnia, hallucinations or transient visual, tactile or auditory illusions, nausea or vomiting, psychomotor agitation, anxiety, convulsive seizures, grand mal ,the symptoms of Criterion 2 result in clinically significant impairment or resonance in personal or social life, the symptoms can not be explained by another pathology The frequency of onset of withdrawal symptoms varies from one study to another, ranging from 13% to 71% [ 1 ] [ 7 ] [ 8 ] [ 9 ] . Some alcoholic patients do not develop a clinical withdrawal syndrome while others have very severe symptoms. 

The main risk factors for the occurrence of withdrawal syndrome are the way in which alcohol is consumed, the presence of coexisting diseases and the existence of genetic factors. In most cases, withdrawal syndrome is a variable association of several types of manifestations [ 7 ] [ 10 ] subjective disorders: to detoxing from alcohol  anxiety, agitation, irritability, insomnia, nightmares. neurovegetative disorders: sweating, tremor, tachycardia, high blood pressure, digestive disorders: anorexia, nausea, vomiting.

Treatment [ 1 ] Objectives, context and conditions of realization

The goal of the detoxing from alcohol   is the entry into a process of complete and sustainable abstention from alcohol. This withdrawal is necessary whenever there is alcohol dependence, whether or not it is expressed by physical signs. To obtain a good quality weaning, several conditions must be met. Achieve optimal comfort and safety conditions to prevent or treat withdrawal syndrome, Provide outpatient or institutional care for prolonged therapeutic follow-up, Help the patient to make the withdrawal process a positive and rewarding long-term personal, family and professional experience. 

Clinical signs remain the essential criteria for evaluating withdrawal syndrome and alcohol dependence. Many scales have been proposed. The severity of withdrawal symptoms can be particularly appreciated by the CIWA- The Cushman index is a clinical scale of severity, usable by medical and nursing staff [ 7 ]. For alcohol dependence, the abbreviated MAST or Michigan Alcoholism Screening Test (MAST) short form, the DETA questionnaire, the French CAGE questionnaire and the Alcohol Use Disorder Identification Test (AUDIT) can be used. The DETA and AUDIT questionnaires are mainly used to screen at-risk consumers, the MAST questionnaire being an aid to the diagnosis of dependence [ 1 ] [ 12