Getting off the grog -- the American way | |
Alcohol withdrawal treatment manual. Paolo B DePetrillo, Mark K McDonough. Glen Echo, USA: Focused Treatment Systems 1999 (xii + 244pp., $115.70). ISBN: 0 9661673 0 9. |
Alcohol withdrawal is
a common problem. Successful management is relatively straightforward, and probably has a great deal to do with the fact that alcohol withdrawal is often overlooked. This book converts the management of alcohol withdrawal into a complex, belief-based, major performance. The senior author, a physician with extensive experience managing alcohol withdrawal, has collaborated with an educationalist. They divide alcohol withdrawal into three categories based on the symptoms and signs of alcohol withdrawal and recommend the different categories be managed with different agents. These categories are: central nervous system excitation, adrenergic hyperactivity, and delirium. They provide data in an appendix which, they assert, validates the rating of the three categories; however, no information is provided to support any predictive or therapeutic value for these ratings. Many patients described by the authors fit multiple categories. The book omits to discuss the integration of alcohol withdrawal management into the healthcare system, the role of nursing in alcohol withdrawal, the administration of multivitamin preparations, or even the need to link alcohol withdrawal management with treatment options promoting long term abstinence. The major strengths of the book are the discussion of a range of pharmacological agents useful in the management of alcohol withdrawal and descriptions of common medical and surgical, but not psychiatric, conditions which may accompany alcohol withdrawal. Although the title suggests that the authors intend this book to be a manual, it is neither written in a suitable style, nor is it detailed enough to be useful for that purpose. The perspective of these American authors is that alcoholism is a disease. They extol a drug-specific approach to the management of dependence. The Australian approach to this subject is generally more pragmatic and emphasises the virtue of a generic approach to alcohol and drug dependence. Increasingly, patients are taking multiple drugs and the notion of providing a dedicated withdrawal service for those dependent on alcohol is from a bygone era. Few readers will be convinced by the authors' perspectives or find their clinical approach rewarding. Alex Wodak
|
New books | All books | Search | Information | Write to us | eMJA Home
© 1999 Medical Journal of Australia