I know that there are inpatient centers alcoholics can go to for treatment and I realize that there is a lot involved with this. I also know the general guidlines for treatment just from talking with people throughout my life.
But I was watching A&E’s Intervention and there was a guy who is being profiled who owns a bunch of tanning bed salons in Vegas and is it is suspected that he is in pretty advanced phases of cirrhosis of the liver, due to having many bruises on his body, delirium tremens and numerous other signs.
They also stated that if he does not have a drink, he gets a big, fat grand mal seizure. Which brings me to my question. If he were to immediately go into treatment, how would they go about treating him? I did not watch the end of this show, maybe they went into details. I know a case this bad wouldn’t be your standard twelve step program either, not medically anywho…
But what medications would they give him since he pretty much NEEDS alcohol to survive at this point? What is protocol at most places, because he obviously needs treatment from a medical doctor and not just an addiction counselor.
Withdrawal from heavy alcohol abuse can cause convulsions and even death. A person is typically put on a benzodiazepine. These are cross-addictive/cross-tolerant with alcohol, but for a variety of reasons are a good intermediate step in the process of helping a person reach sobriety.
I’m not sure what you mean. If you mean “all the medical care they get,” they get other kinds of monitoring and potentially other kinds of medical care. If you mean “all the substances they get,” possibly so. If you mean “all the treatment they get,” the answer is that during detox people are usually not interested in much and may watch a lot of TV, pace, or sleep. After acute detox, they would be likely to spend much of their day in group interventions. Depending on the treatment facility, this might be a combination of group therapy, cognitive-behavioral training, social skills and goals setting groups, talks on addiction issues, nutritional and exercise consultation, exercise groups, and 12-step groups; and family and individual therapy.
If withdrawal is a problem, they get put on a benzo taper.
If hepatic encephalopathy is a problem, they get put on a low protein diet or lactulose or similar to lower their serum ammonia levels.
If they’re malnourished, they get appropriate caloric and vitamin supplements to correct that and prevent the complications.
If they’ve aspirated their own vomit and gotten ARDS, they get put on a ventilator, and get a boatload of drugs to see if they can be kept from dying.
If they’ve got bleeding esophageal varices they get beta-blockers to lower blood pressure and acid blockers to prevent erosions.
If they’ve got a massive amount of fluid in their abdomen, they get put on spironolactone to try to diurese some of it out.
If their blood won’t clot properly, they may get vitamin K, or get taken off aspirin, or just told to try not to fall down.
Etc.
For more details consult Harrison’s textbook of Medicine.
Most alcoholics in an inpatient treatment program must get medically cleared at the start, so these issues are put to rest, or at least managed properly, while they get on with their rehab.