Our patients are prone to drug and alcohol misuse so correctional nurses need heightened awareness of withdrawal potential for all who enter their facilities. According to authorities, more than 65% of inmates meet criteria for drug abuse, alcohol dependence, and addiction. There are also significant concerns about deaths while in custody related to drug and alcohol withdrawal. Of the two, alcohol withdrawal has significantly higher concerns but withdrawal from opiates and depressant drugs can also cause problems.
Intake assessment of withdrawal potential is critical for good care. CAGE is a standard evaluation of alcohol intake that can quickly determine if withdrawal is likely. Two positive responses are considered a positive test and indicate further assessment is warranted.
C – Have you ever felt you should cut down on your drinking?
A – Have people annoyed you by criticizing your drinking?
G – Have you ever felt bad or guilty about your drinking?
E – Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
Correctional nurse and chapter author Susan Laffan has a list of other questions that should be asked during intake:
- Do you currently use any type of alcohol or drugs?
- If “no”: has the individual used in the past?
- What type?
- alcohol: beer/wine/liquor
- drugs: illegal vs. prescription (dosage)
- name of each drug
- route of drug (oral/smoke/inhaled/intravenous)
- How much/many?
- How often?
- Date and time last used?
- Have you ever had withdrawal symptoms or seizures/“shakes” when alcohol/
- drug is stopped?
- Have you ever been hospitalized for medical treatment of withdrawal
What do you use to evaluate for alcohol withdrawal potential? Share your tips in the comments section.
Read more about withdrawal detection and management in correctional nursing practice in Chapter 5: Alcohol and Drug Withdrawal from Essentials of Correctional Nursing. Order your copy directly from the publisher. http://www.springerpub.com/product/9780826109514#.UDqoiNZlQf4