Summary alcohol withdrawal syndrome hospital management

Alcohol
Withdrawal:
Recognition and
Inpatient
Management
Dr Joven Mailvaganam
Addiction Psychiatrist
Department of Psychiatry, Sarawak
General Hospital

,Agenda
01 Pathophysiology of AWS
02 Clinical Spectrum of AWS
03 Risk Assessment & Monitoring
Management Approach (Supportive +
04
Pharmacological)
05 Wernicke’s Encephalopathy
06
Special Populations

, Alcohol Use in Malaysia & Sarawak
• Prevalence of current
alcohol use: 11.8%
• Among drinkers: 45% Risky drinkers mor
NMHS 2019 Malaysian adults Binge Drink, 23.6% develop withdrawa
engaged in Heavy abruptly stopped.
Episode Drinking.

• Current alcohol use:
NHMS Adolescent Health 7.4% nationally
Early use → ↑ risk
Survey, 2022 (Sarawak Adolescents (13–17 yrs) • Regional report: Sarawak
dependence & late
report) adolescents among
higher prevalence groups
• Iban & Bidayuh men:
much higher prevalence
Rural Sarawak young
of alcohol use vs Malay Highlights ethnic &
men study (Iban, Rural villages (Samarahan,
(Muslim) peers cultural differenc
Bidayuh, Malay, ages 18– Sarawak)
• Hazardous drinking for AWS in Sarawak
30)
concentrated in non-
Muslim groups
• Abstainers: 11%
3% alcohol depen
• Low-risk drinkers: 50%
Dayak adolescents study Dayak adolescents (mean adolescents alrea
• Hazardous: 31%
(Sarawak, 2023) age 17.3 yrs) of withdrawal synd
• Harmful: 5%
abruptly stopped.
• Alcohol dependent: 3%