Mark’s Alcohol Withdrawal Syndrome

Grand Canyon University

Abstract

This essay analyses the case of Mark who visited the hospital exhibiting symptoms of severe Alcohol Withdrawal Syndrome (AWS). The signs that are observed in Mark to arrive at this diagnosis have been described in this composition. Additionally, the best course of action that should be applied to Mark has been stated in this essay. It is proper that Mark is hydrated, replenished with vitamins and electrolytes, and is medically treated to prevent the progressing of his symptoms towards death. By assessing his symptoms and comparing them to the DSM-V criteria, it is evident that Mark has Alcohol Use Disorder.

Keywords: AWS, AUD, AWS treatment

Mark’s Alcohol Withdrawal Syndrome

Alcohol Withdrawal Syndrome (AWS) is a condition of painful symptoms that result when an alcoholic stops consuming alcohol. Even though AWS can cause chronic pain in the patient, it can also lead to death in severe cases. The illness can also be caused by a reduction in the rate of alcohol consumption (Medina, 2017). Mark’s signs reveal that he has AWS. Since he states that he has not taken a drink in twenty-four hours and says he only sipped alcohol, it is evident that the symptoms he exhibits are due to the cessation and reduction of his alcohol consumption; which has been high since he was a teenager. Additionally, his CIWA score is higher than twenty, which indicates severe withdrawal. It is vital to analyze the symptoms of acute AWS in Mark and use them to design an appropriate course of treatment and a proper DSM-V diagnosis.

The DSM-5 symptoms of AWS are autonomic hyperactivity, hand tremors, insomnia, nausea or vomiting, hallucinations, psychomotor agitation, anxiety, and generalized tonic-chronic seizures (Schuckit, 2014). However, for a person to be diagnosed with acute AWS they have to exhibit constant nausea with heaving, severe tremors with hand extended, sweating that drenches, continuous hallucinations, extremely severe headaches, and pacing (Schuckit, 2014). Mark exhibits most of these signs. He is observed to vomit in his emesis bag continuously, and when requested to extend his arms, severe tremors are seen in his hands and shoulders. Mark also reports of a severe headache that he rates at a scale of five out of ten. Furthermore, as he was seated in the interview room, indicators of extreme sweating that drenched his clothes and sweat droplets forming all over his face were observed. Besides the above criteria; systolic blood pressure, increased heart rate and rise or decrease in body temperature are biomarkers that are effective for determining severe AWS (Jesse et al., 2016). Mark reveals an increase in blood pressure from 149/97 to 154/103 and a rise in his heart rate by the increase of the pulse from 104 to 114. The severe sweating exhibits a rise in body temperature.

It is critical that Mark undergoes immediate treatment to prevent further worsening of his symptoms. First, the medical staff should try and re-orient Mark to his present condition and sufficiently protect his airway. Additionally, they should check Mark’s hydration levels and hydrate him if it is low (Schmidt et al., 2016). Since Mark has also stated that he has been unable to eat, there are high chances that his body lacks adequate nutrients. Additionally, the constant vomiting emits a lot of vitamins and electrolytes from his body. Therefore, the physicians and nurses should work on replenishing vitamins and electrolytes in Jack’s body (Schmidt et al., 2016). Moreover, the practitioners should also detoxify Mark immediately to reduce the alcohol concentration present in his body organs.

In cases of severe AWS, Benzodiazepines are the most recommended form of medication (Schmidt et al., 2016). Examples of these drugs are lorazepam, chlordiazepoxide, oxazepam, and diazepam. These medications aim to prevent withdrawal and withdrawal-related seizures. The combination of the above steps would be the best form of treatment for Mark. Additionally, other remedy options that have minimal evidence of their treatment for AWS such as the use of Phenobarbital, Propofal, and Dexomedetomidine can also be applied (Schmidt et al., 2016).

For an accurate diagnosis for Mark, it is vital to assess his symptoms and compare them to the DSM-V criteria. The DSM-V states that the signs for Alcohol Use Disorder (AUD) are consuming copious amounts of alcohol for more extended periods than intended, failure to control alcohol use, long periods spent obtaining alcohol, and alcohol use disturbing social and personal relationships. Also, the other signs include risky behavior due to drinking, neglect of duties, absence from school or work, continued use even when one is aware of the problems caused by alcohol, and relationship issues or violence. Other symptoms of AUD are the use of alcohol in dangerous situations and difficulties managing finances (Dziegielewski, 2015). The DSM-V states that a person who illustrates two of the above indicators for twelve months or more should be diagnosed with the illness. Mark exhibits more than two of these symptoms. He has been abusing alcohol since he was sixteen years and has not been sober for the past seven years, hence meeting the twelve-month criteria. His alcohol abuse has also led to his unhealthy financial habits of gambling between five hundred dollars and one thousand dollars every weekend. Additionally, his consumption has led to social problems since he has been arrested for Driving under the Influence several times in the past fifteen years. Mark’s alcohol abuse has led to problems in his marriage, and his wife has threatened to divorce him many times. Despite all of these problems caused by his alcohol consumption, Mark has not quit drinking, and he reported that he had tried to stop his alcohol abuse but was unsuccessful. Therefore, Mark can be diagnosed with Alcohol Use Disorder.

Due to the symptoms, he reveals during his visit to the hospital; it is evident that Mark has severe AWS. Therefore, the medical practitioners should treat him immediately by replenishing vitamins, water, and electrolytes. They should also detoxify Mark to reduce the concentration of alcohol in his body organs and administer appropriate medication such as Benzodiazepines. Since Mark meets the DSM-V criteria, he can be accurately diagnosed with AUD.

References

Dziegielewski, S. F. (2015). DSM-5 in action. Hoboken, New Jersey: John Wiley & Sons, Inc.

Jesse, S., Bråthen, G., Ferrara, M., Keindl, M., Ben-Menachem, E., Tanasescu, R., … Ludolph, A. C. (2016). Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurologica Scandinavica, 135, 4–16. https://doi.org/10.1111/ane.12671

Medina, J. (2017, August 24). DSM-5 Alcohol Withdrawal Symptoms. Retrieved May 1, 2018, from https://psychcentral.com/disorders/alcohol-withdrawal/

Schmidt, K. J., Dosh, M. R., Holzhausen, J. M., Natavio, A., Cadiz, M., & Winegardner, J. E. (2016). Treatment of Severe Alcohol Withdrawal. Annals of Pharmacotherapy, Vol. 50(5), 389 –401. https://doi.org/10.1177/1060028016629161

Schuckit, M. A. (2014). Recognition and Management of Withdrawal Delirium (Delirium Tremens). The New England Journal of Medicine, 371(22). Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJMra1407298