Patient discussions
If considering discharge (without admission), advise the patient to continue drinking alcohol. Stopping abruptly may lead to severe withdrawal. If possible, the patient should gradually reduce their intake over several weeks/months. It is common practice to advise them to decrease their level of drinking by not more than 25% every 2 weeks.
Pay attention to why the patient has stopped drinking. They may have run out of money or feel too unwell (owing to concomitant illness) to drink alcohol and are therefore at higher risk of developing worsening symptoms if they aren’t admitted for medically assisted withdrawal.
Never advise a patient who is being discharged to suddenly stop or reduce their drinking as this could precipitate severe symptoms. Signpost to outpatient services where controlled withdrawal can be organised.[1] Check local protocols for what is available and recommended in your area.
Many patients who are alcohol-dependent manage their withdrawal symptoms every day with continued alcohol consumption. It is often appropriate to continue this until the patient can be assessed formally by addiction services to determine the best treatment for their alcohol dependence.[2]
Give general advice regarding a healthy lifestyle, including intake of a balanced diet with the recommended daily allowance of vitamins, especially thiamine.
Give the patient advice on guideline-led recommended limits of alcohol. In the UK, the Chief Medical Officers' guideline states that it is safest not to drink more than 14 units a week on a regular basis.[192]
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