So far, I have witnessed four different patients go into a full-blown convulsive seizure as a result of alcohol or drug withdrawal. Let me tell you, it is extremely disturbing to see this happen. When a person experiences a Grand Mal Seizure, not only do they convulse, they actually stop breathing for a period. One minute you and the patient are carrying on a regular conversation, and the next, his eyes are rolling back into his head and he is convulsing, foaming at the mouth, and turning blue.
I guess I am pretty naive, I don’t drink, and have never smoked or done drugs, so it has always been pretty shocking for me to see someone suffer from the effects of substance abuse withdrawal. It also took me a while to cue myself in on these types of patients. So, if you are a nurse reading this post, pay very close attention to those patients who have a fine hand tremor, are irritable, and constantly begging for pain meds/narcotics. The ones who stay at a 10 out of 10, and especially the ones who are threatening to leave Against Medical Advice (AMA). Usually they are just dying to get their hands on a drink or fix.
In every hospital I have ever worked in, we nurses have always been required to ask all newly admitted patients about their alcohol and street drug use during our Admission Assessment. In every one of the severe cases of delirium tremens I have witnessed, the patient either did not disclose their addiction at all, or drastically downplayed their addiction during the admission interview telling the nurse they only drink one glass of Jim Beam per week, when actually they drink one fifth per day.
When a person stops consuming alcohol abruptly after prolonged periods of excessive consumption, this causes the central nervous system to go into a hyper-excitable state. They begin to experience a certain set of symptoms when seen together is known as Alcohol withdrawal syndrome. The withdrawal is going to vary in severity depending on how much alcohol and/or drugs the person has been taking, and for how long. The most commonly seen symptoms are: Irritability, tremors, sweating, rapid heart rate, extreme confusion, fever, and seizures. Seizures carry the biggest risk since they can cause brain damage.
If you or someone you know is addicted to drugs or alcohol, please remember to make sure to disclose this information up front as soon as you are admitted to the hospital. It’s not worth the risk. Thanks to HIPAA, nurses and medical staff are not allowed to share or discuss your medical information with your loved ones or anyone else for that matter without your signed, informed consent.
There is hope even for the most severe alcoholics. These severe cases can and should be managed in an inpatient environment. Most doctors have a standing order protocol for alcoholic patients that includes regular doses of long-acting barbituates and often they even prescribe tapered servings of beer. You don’t have to be admitted for the purpose of de-toxing to be treated for your alcoholism. You can be treated concurrently while you are there for other issues. Just talk to your doctor.