Introduction
Alcohol use disorders such as alcohol dependence are a preventable problem that failed to be addressed can lead to severe complications and eventually died as a result. More than a third of the American population consumes alcohol at a rate that can lead to harm according to the survey (Gordon and Saitz, 2004). Alcohol disorders contribute to about 100,000 deaths in the United States and research has revealed that men are more affected compared to women. Alcohol withdrawal syndrome is a physical and mental problem that is resulted from a sudden reduction or complete cessation of alcohol intake (Trevisan et al, 1998). This paper is going to discuss in detail the diagnostic markers, course of action, and a DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnosis for Mark as indicated in the Case Study.
People Also Read
Diagnostic Markers for Acute Alcohol Withdrawal Syndrome
Alcohol withdrawal syndrome symptoms range from mild to serious depending on how much has been consumed and for how long. According to the case study, Mark has been a long term and alcohol-dependent person from the age of 16; this situation worsened as he grew older. These symptoms can be seen as early as 6 hours after consumption. The mild symptoms are anxiety, nausea, vomiting, headache insomnia sweating, and shaking (Ambardekar, 2017). These symptoms can fade away without treatment for mildly alcohol dependent persons. Since Mark is a serious long term alcohol-dependent person, he experienced severe symptoms of alcohol withdrawal syndrome. According to the case study Mark had stayed for approximately 24 hours from when he last consumed alcohol. The diagnostic markers that show Mark are experiencing alcohol withdrawal syndrome include;
Seizures
Mark reported that he was once taken to an emergency room after a generalized seizure characterized by loss of consciousness and vicious muscle contractions. This was a result of an abrupt cessation of alcohol intake which the ER doctor advised against to avoid reoccurrence of seizure. According to Trevisan et al (1998) seizures are one of the serious alcohol withdrawal symptoms that occur in more than 5% of acute alcohol withdrawal patients. Seizures are episodes of uncontrolled electrical activities in the brain. They mostly occur 48 hours after the person completely stops alcohol consumption.
Delirium Tremens
This is a clear diagnostic marker that Mark poses which usually develops from 1 to 4 days after a person stops drinking alcohol. It is associated with brain and nervous system problems. Delirium Tremens is mostly experienced by persons who have been alcohol dependent for a long time. Mark experienced the following characteristics of delirium tremens; excessive sweating visible on his forehead and neck and sweat beads can be seen from his shirt on the chest and back, disturbed state of mind, frequently apologizing showing confusion, he had an elevated heart rate of 114, he had a sensitivity to light and sounds; this is evident when he talked softly away from the noise at the hallway and asking if the ceiling lights can be turned off. Involuntary muscle contraction is also one of the characteristics of delirium. Mark had visible tremors on his arms and shoulders when he was asked to stretch out his arms. Anxiety was a visible symptom from the sweats he had, rapid breathing, and restlessness which was observed during the interview (Trevisan et al, 1998). Mark’s skin looks old according to the case study which is a result of dehydration. The irregular heart rate and blood pressure noted are one of the signs that show the patient is experiencing Delirium tremens.
Appropriate Course of Action for Mark
After the observation by the clinician and undergoing the diagnostic criteria recorded in the CIWA scale, Mark has severe alcohol withdrawal syndrome. The immediate cause of action is to stabilize the pulse rate and blood pressure and correct the disturbances of water and nutritional balances. The fluids in the blood play a major role in the functioning of the heart and kidney and also correct the state of dehydration and sweating that Mark was experiencing. Mark should be given electrolytes supplements especially magnesium to reduce the general withdrawal symptoms which cause metabolic abnormalities (Anton and Myrick, 1998). Mark should further undergo more physical examination to detect the possibility of any other conditions that co-occur with alcoholism such as liver disease, pancreatic disease, any infectious disease such as tuberculosis, bleeding within the digestive system, and check for impairment in the nervous system.
Appropriate DSM Diagnosis for Mark
The symptoms of alcohol withdrawal according to DSM -5 occur within several hours to a few days after cessation of alcohol use. They include insomnia, increased hand tremor, autonomic symptoms, nausea/vomiting, anxiety, psychomotor agitation, hallucinations, and seizures. A patient experiencing a combination of two or more of the mentioned symptoms satisfies the DSM -5 criteria for alcohol withdrawal syndrome. Impairment of other areas of functioning in daily life such as social and occupational is also a determining factor according to the DSM-5 (Medina, 2017). Mark meets the DSM – 5 criteria for alcohol withdrawal syndrome because he experiences more than two of the stated symptoms. In addition to that, he is also facing distress at his workplace and in his marriage. He describes his marriage as a disengaged relationship and his wife had threatened to divorce him. On the other hand, he is considered an unreliable worker because his brother covers for him most of the time when he is drinking.
References
Ambardekar, N. (2017). Alcohol Withdrawal: What Happens When You Stop Drinking?. Retrieved from https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments#1-3
Gordon, A., & Saitz, R. (2004). Identification and Management of Alcohol Use in Disorder in Primary Care. Retrieved from http://www.turner-white.com/pdf/jcom_jul04_alcohol.pdf
Medina, J. (2017). DSM-5 Alcohol Withdrawal Symptoms. Psych Central. Retrieved on July 13, 2018, from https://psychcentral.com/disorders/alcohol-withdrawal/
Myrick, H., & Anton, R. (1998). Treatment of Alcohol Withdrawal. Retrieved from https://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf
Trevisan, L., Boutros, N., Petrakis, I., & Krystal, J. (1998). Complications of Alcohol Withdrawal. Retrieved from https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf
With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.
