British Columbia

Alcohol-withdrawal patient assessment is flawed and strains health-care system: study

A report by the B.C. Centre on Substance Abuse found that doctors and administrators often over-admit people into alcohol withdrawal management care in B.C.

Many unnecessarily receiving care for severe alcohol withdrawal syndrome, B.C. Centre on Substance Abuse says

Dr. Evan Wood says resources are being wasted on admitting people to hospital treatment programs for alcohol withdrawal when they may be better suited to outpatient services. (Justin Sullivan/Getty Images)

Researchers at the B.C. Centre on Substance Use say the system that hospitals use to assess and admit people at risk for severe alcohol withdrawal syndrome (SAWS) is flawed.

A report published Tuesday found that doctors and administrators often over-admit people into alcohol withdrawal management care in B.C. 

Dr. Evan Wood, executive director of the B.C. Centre on Substance Use and primary author of the report, titled Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?, says people coming forward with serious alcohol addiction are often admitted to hospital treatment programs that aren't always necessary.

"These [withdrawal symptoms] can be a life-threatening emergency, and so that's where we know we need to provide good care, but the health-care system has overreacted," he said.

"That leads to over-usage of health-care resources."

Checklist solution

SAWS often presents itself in the form of delirium tremens and seizures. 

Wood says that only about one per cent of people that are addicted to or consume heavy amounts of alcohol experience SAWS, and the rest could be effectively managed through outpatient services. 

The solution, he says, is better assessing who is most at risk.

"Among the things we identified was that there is a simple, quickly administered checklist — called the Prediction of Alcohol Withdrawal Severity Scale — that can be administered in a minute or two," he said.

Wood says the questionnaire is reliable in identifying those who are most at risk, and those who can be referred to other outpatient services.

"If you don't need to be admitted and away from work and family, that's probably much safer and better for the patient in the long run."

'Playing catch-up'

Wood says that this type of test is something already used in other areas of health care, where there are standardized tests used to determine a patient's risk level and whether or not they require immediate care.

"This isn't reinventing the wheel, but it's playing catch-up for how we provide addiction care and modernizing that so that it's consistent with other diseases," he said. 

"The care that people with alcohol addiction receive is functioning at maybe a 1970s level."

Listen to the full interview with Dr. Evan Wood:

With files from On the Coast

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