Question:
Has anyone on the list have experience or use a Symptom triggered Dextox
protocol for Alcohol Withdrawal Syndrome.
I'm currently revising the one at our hospital that uses a fixed dose
protocol and there is not flexibility with it right now.
Answer:
I'd be interested in hearing the response to this. I work on a detox unit
and we use an Ativan protocol...occassionally will use a Valium protocol.
I'm not exactly sure what you mean by a "symptom triggered detox protocol"?
At our facility we have some lee-way in regards to giving 1 or 2 mg and
whether it is oral or IM...anyways...would be interested in hearing
responses. Not many discussions here regarding chem dep or detox.
I worked in an inpatient unit that used the 12 Step model. Folks with physical
symptoms during detox would get Librium (increase in pulse rate, BP, tremors).
There was a great deal of caution in assessing folks during detox, so's things
didn't get out of hand A highly dangerous process if mis-managed. There was
very little prescription drug use, no staff psychiatrists. No mucking around
with trials of antidepressants; the philosophy was that you couldn't know
whether there was true clinical depression until you got off alcohol/drugs,
learned to deal with life's troubles in basic appropriate ways. Had MSW
clincial director, MD's with good background in 12 Step, and RN's on all
shifts. Counselling support staff were generally aids who were in recovery
themselves. There were no pharm drugs available "because I feel bad" - even
pain meds required attempt at using other means of pain control first. This was
an open unit, free to leave if you don't like the program (although many were
court referred). Tylenol for a headache was fine, after trying lying down in a
dark room, cold compress to your head, etc. Same with back pain. There were
substantial numbers of patients with "chronic pain" who were "cured" in
drug/alcohol rehab. There were others with chronic problems whose pain had been
masked by drug/alcohol use who discovered their problems when they stopped
self-medicating.
