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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="National Clinical Guideline Centre (UK)" /><meta name="citation_title" content="Alcohol Use Disorders" /><meta name="citation_publisher" content="Royal College of Physicians (UK)" /><meta name="citation_date" content="2010" /><meta name="citation_author" content="National Clinical Guideline Centre (UK)" /><meta name="citation_pmid" content="22876380" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK65576/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Alcohol Use Disorders" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="Royal College of Physicians (UK)" /><meta name="DC.Contributor" content="National Clinical Guideline Centre (UK)" /><meta name="DC.Date" content="2010" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK65576/" /><meta name="description" content="Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline." /><meta name="og:title" content="Alcohol Use Disorders" /><meta name="og:type" content="book" /><meta name="og:description" content="Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK65576/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg100-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="warning" content="August 2019: Some glossary terms were updated by NICE, and the recommended alcohol units for men and women were updated in line with advice from the UK Chief Medical Officer." /><meta name="bk-non-canon-loc" content="/books/n/nicecg100/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK65576/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/nicecg100guid/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg100guid-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/nicecg100guid/">See 2018 Partial Update</a></span></li></ul></div></div></div><div class="messagearea bk_noprnt" style="margin-bottom:1.3846em "><ul class="messages"><li class="warn icon"><span class="icon">August 2019: Some glossary terms were updated by NICE, and the recommended alcohol units for men and women were updated in line with advice from the UK Chief Medical Officer.</span></li></ul></div><div class="bk_prnt"><p style="color:red;"><strong>August 2019: Some glossary terms were updated by NICE, and the recommended alcohol units for men and women were updated in line with advice from the UK Chief Medical Officer.</strong></p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.rcplondon.ac.uk/Pages/index.aspx" title="Royal College of Physicians (UK)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg100-lrg.png" alt="Cover of Alcohol Use Disorders" /></a><div class="icnblk_cntnt"><h1 id="_NBK65576_"><span itemprop="name">Alcohol Use Disorders</span></h1><div class="subtitle">Diagnosis and Clinical Management of Alcohol-Related Physical Complications</div><p><i>NICE Clinical Guidelines, No. 100</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Clinical Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="http://www.rcplondon.ac.uk/Pages/index.aspx" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">Royal College of Physicians (UK)</span></a>; <span itemprop="datePublished">2010</span>.</div><div><a href="/books/about/copyright/">Copyright</a> © 2010, National Clinical Guidelines Centre.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Excerpt</h2><p>Alcohol is the most widely used psychotropic drug in the industrialised world; it has been used for thousands of years as a social lubricant and anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of adult women drink in a hazardous or harmful way. Levels of hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the north (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered amongst hospital attendees; 12% of emergency department attendances are directly related to alcohol whilst 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. Continued hazardous and harmful drinking can result in dependence and tolerance with the consequence that an abrupt reduction in intake might result in development of a withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can also result in damage to almost every organ or system of the body. Alcohol-attributable conditions include liver damage, pancreatitis and the Wernicke’s encephalopathy. Key areas in the investigation and management of these conditions are covered in this guideline.</p></div><div><h2>Contents</h2><ul id="toc_tllNBK65576_toc_nicecg100_fm_s1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK65576_toc_nicecg100_fm_s1"><a class="toc-item" href="/books/n/nicecg100/nicecg100.fm.s1/">Guideline Development Group</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_nicecg100_fm_s3"><a class="toc-item" href="/books/n/nicecg100/nicecg100.fm.s3/">Declarations of Interest</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch1_s1"><a class="toc-item" href="/books/n/nicecg100/ch1.s1/">1.1 Glossary Of Terms</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch1_s2"><a class="toc-item" href="/books/n/nicecg100/ch1.s2/">1.2. Background</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch1_s3"><a class="toc-item" href="/books/n/nicecg100/ch1.s3/">1.3. Methodology</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2"><a class="toc-item" href="/books/n/nicecg100/ch2/">2. Acute Alcohol Withdrawal</a><ul id="toc_lst_NBK65576_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s1"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s1">2.1. Admission to hospital</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s30"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s30">2.2. Treatment for acute alcohol withdrawal</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s46"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s46">2.3. Dosing regimens</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s66"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s66">2.4. Management of Delirium Tremens</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s73"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s73">2.5. Treatment of alcohol withdrawal seizures</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s81"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s81">2.6. Assessment and monitoring</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch2_s106"><a class="toc-item" href="/books/n/nicecg100/ch2/#ch2.s106">2.7. Wernicke’s encephalopathy</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch3"><a class="toc-item" href="/books/n/nicecg100/ch3/">3. Alcohol-related liver disease</a><ul id="toc_lst_NBK65576_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch3_s1"><a class="toc-item" href="/books/n/nicecg100/ch3/#ch3.s1">3.1. The role of the liver biopsy</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch3_s32"><a class="toc-item" href="/books/n/nicecg100/ch3/#ch3.s32">3.2. Referral for consideration of liver transplantation</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch3_s41"><a class="toc-item" href="/books/n/nicecg100/ch3/#ch3.s41">3.3. Corticosteroid treatment for alcohol-related hepatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch3_s58"><a class="toc-item" href="/books/n/nicecg100/ch3/#ch3.s58">3.4. Nutritional Support for alcohol-related hepatitis</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4"><a class="toc-item" href="/books/n/nicecg100/ch4/">4. Alcohol-related Pancreatitis</a><ul id="toc_lst_NBK65576_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s1"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s1">4.1. Diagnosis of Chronic alcohol-related pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s9"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s9">4.2. Diagnosis of acute alcohol-related pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s10"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s10">4.3. Pancreatic surgery versus endoscopic therapy for chronic alcohol-related pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s40"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s40">4.4. Prophylactic antibiotic treatment for acute alcohol-related pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s57"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s57">4.5. Nutritional support for acute alcohol-related pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_ch4_s89"><a class="toc-item" href="/books/n/nicecg100/ch4/#ch4.s89">4.6. Enzyme supplementation for chronic alcohol-related pancreatitis</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app1"><a class="toc-item" href="/books/n/nicecg100/appendixes.app1/">A.1. Corticosteroids versus placebo forest plots</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app2"><a class="toc-item" href="/books/n/nicecg100/appendixes.app2/">A.2. Clinical questions and literature searches</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app3"><a class="toc-item" href="/books/n/nicecg100/appendixes.app3/">A.3. Health economic analysis – dosing regimens for acute alcohol withdrawal</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app4"><a class="toc-item" href="/books/n/nicecg100/appendixes.app4/">A.4. Health economic analysis – surgery vs endoscopy for chronic pancreatitis</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app5"><a class="toc-item" href="/books/n/nicecg100/appendixes.app5/">A.5. Scope</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app6"><a class="toc-item" href="/books/n/nicecg100/appendixes.app6/">A.6. Referral from the Department of Health</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_appendixes_app7"><a class="toc-item" href="/books/n/nicecg100/appendixes.app7/">A.7. Reference list</a></li><li class="half_rhythm" id="toc_itm_NBK65576_toc_nicecg100_chevidencetables"><a class="toc-item" href="/books/n/nicecg100/nicecg100.chevidencetables/">Evidence Tables</a></li></ul></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2010, National Clinical Guidelines Centre.<p class="small">Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.</p></div><div class="small"><span class="label">Bookshelf ID: NBK65576</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/22876380" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">22876380</a></span></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg100/nicecg100.fm.s1/" title="Next page in this title">Next ></a></div></div></div></div>
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