Resources on drug/alcohol detox

putterfly74 · Jan 26, 2006

Hi there. Iwork on ahosp based detox. There is not alot out there. I found a new site. Look under drug and alcohol certification. Alot of study materials to be found. putterfly74:rotfl:

CharlieRN · Feb 2, 2006

Hello again!
I need to call upon your expert advice in this forum to get pointed to a few outstanding resources on drug/alcohol detox.
Specifically, I'm looking for books/websites that have a good rundown of detoxing for both based on nursing assessment. I am looking for info on common lab results and physical response. I am looking for the common timeline of detox and its patho/labs etc.
I have been running into an ever-increasing number of 'atypical detoxers'...people who are admitted for suicidal ideation for example that have been 'power triaged' through ED to hit the unit sans labs etc, and begin detoxing 48-72 or more hours later. This generally means I have absolutely no baseline and now I have to figure out what is going on.
I have a lot of this info in various sources but am looking for a 'manual' of sorts that brings it all together. Anyone know of such an animal?
Thanks in advance!
~IMBC

do you have a detox protocol? If you don't, put one together and offer it to your Docs for input and approval. It should detail frequency of vital signs, prn meds and the reasons to give them, it should includes a scale to measure withdrawal sx and ordered benzos to control withdrawal sx based onthe number the patient scores. It should identify the labs that will have been drawn before the patient is admitted or on admission. Make it in the form of an order form that the er doc will have infront of him when he is admitting a pt to you unit.

EricTAMUCC-BSN, BSN, RN · Feb 2, 2006

okay, okay, I know its not peer reviewed, but they are eye witnesses.

http://www.soberrecovery.com/forums/

mshrn · Feb 5, 2006

We screen for alcohol withdrawal using the CIWA protocol...all patients with a history of alcohol abuse and those drinking prior to admission are screened for at least the first twenty-four hours. CIWA assessment generates a score and patients are given librium or ativan as needed. All patients are given urine drug screen as soon as possible after admission...opiate-addicted patients are treated with decreasing doses of clonidine over several days and prns for somatic symptoms.

leonogist · Feb 7, 2006

Here is a good rersource for various detox protocols

AThe district I work in is light on for medical staff so we often have to give out advice to local gp's etc and generally its sourced from this follow this link and you will find happy detox land http://www.health.qld.gov.au/atods/documents/24904.pdf :coollook:

liandra · Feb 16, 2006

Leonogist... Thankyou for the wonderful detox resource!

putterfly74 · Feb 16, 2006

We also use a CIWA for ETOH patient and the COWS for opiates. We are working on a more uniform scoring for PRN meds. Does anyone know of any other forms or information. A step by step non chemical interventions rather than prns for low scores? Thanks putterfly74

nursekelly217 · Feb 18, 2006

Anyone able to give me more info on the COWS system for assess opiate w/d? Our facility uses a very vague and mostly subjective scale and our patients can rattle of the qualifying sx better than me training a new detox nurse! I hate thinking I'm "intoxicating" someone who doesn't really need a detox (rather needs a warm bed and a few good meals.)

putterfly74 · Feb 20, 2006

The cows scale is located on the ASAM web site . It looks at VS, tearing and nasal congestion chills myalgia,arthalgia,nausea. The systems are rated by numbers and then you can make a decision if medication is required. Axiety is also assessed. Good luck

CharlieRN · Mar 6, 2006

The various scales are usually well tought out and researched. There is no substitute for experienced professional judgement and a clear eyed sceptical but friendly attitude. Addicts will lie to you. It is a symptom of the illness. However, punativeness has no legitimate part in your theraputic response. You are friendly toward the people you serve but they are not your friends, so they don't owe you honesty. It is not reasonable to be insulted when they lie to you. You would not be insulted that a person with pneumonia had a fever, would you? Lying is a symptom. So you should weight your scale toward the objectively observable symptoms and away from the subjectively reported ones. ie: We score vomiting and diarrhea only if observed and verified by staff.

Thunderwolf, MSN, RN · Mar 7, 2006

the various scales are usually well tought out and researched. there is no substitute for experienced professional judgement and a clear eyed sceptical but friendly attitude. addicts will lie to you. it is a symptom of the illness. however, punativeness has no legitimate part in your theraputic response. you are friendly toward the people you serve but they are not your friends, so they don't owe you honesty. it is not reasonable to be insulted when they lie to you. you would not be insulted that a person with pneumonia had a fever, would you? lying is a symptom. so you should weight your scale toward the objectively observable symptoms and away from the subjectively reported ones. ie: we score vomiting and diarrhea only if observed and verified by staff.

most excellent post. objectivity is the key.