Safe Alcohol Consumption Guidelines

Healthy Adults No more than 2 standard drinks (20 grams) at any given time to reduce life time risk of alcohol related harm or disease No more than 4 standard drinks (40 grams) at any given time to reduce risk of alcohol related harm or injury from that occasion Pregnant and Breastfeeding Women Not drinking … Continue reading Safe Alcohol Consumption Guidelines


Opioid Substitution Therapy

Opioid intoxication Opioid withdrawal slow sleepy hypotensive bradycardic hypopnoeic constricted pupils constipation "on the nod" agitated dilated pupils tachycardia hypertension piloerection (goosebumps) "orange peel" skin nausea, vomiting diarrhea wet signs: clammy/sweaty, tears, runny nose yawning headache and body cramps Choice of withdrawal Methadone Buprenorphine  Pure μ opioid receptor agonist Partial μ opioid receptor agonist,  ↑ efficacy ↓ … Continue reading Opioid Substitution Therapy

Alcohol dependence

Features Drink driving (2 or more significant for dependence) Rescue drink (i.e. midnight, lunch) Perceptual changes (hallucinations) when alcohol is stopped, i.e. due to illness can be as subtle as shapes/colours appearing to change Seizures (in withdrawal) Concurrent use of benzodiazepines i.e. valium (diazepam) Hiding alcohol supply and drinking behaviour Frequent blackouts This refers to … Continue reading Alcohol dependence


Mechanism of Action Opioid antagonist reversible blockage of of opioid receptors (24-72 h), preventing opioid effects i.e. euphoria Alcohol dependence reduces cravings for alcohol and possibly reduces some of its pleasurable effects by blocking effects of endogenous opioids Adverse effects nausea, headache, dizziness, anxiety, fatigue, insomina and sleepiness Contraindications Physical dependence on opioids or acute … Continue reading Naltrexone

Alcohol Withdrawal Delirium (Delirium Tremens)

Alcohol withdrawal delirium should be treated as a medical emergency as it has a mortality rate of up to 4%. If the patient does not respond to early treatment, management may need to occur in a highly monitored environment such as an intensive care or a high-dependency unit. Furthermore, the degree of sedation required for … Continue reading Alcohol Withdrawal Delirium (Delirium Tremens)