Opiates in Ethanol Withdrawal

Tsueda, Kentaro; Ge, Loyd; Mf, Heine; Duque, Fernando Luis Vieira; Je, Haas; Je, Stocking

doi:10.1097/00000539-199510000-00039

Cited by 3 publications

(1 citation statement)

References 20 publications

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“… 29 Tsueda et al reported the use of opioids to suppress DT in three patients and postulated that opioid deficiency in the CNS may be related to AWS. 30 This viewpoint has been supported by some human and animal studies. 31 , 32 …”

Section: Discussionmentioning

confidence: 84%

Morphine for Intravenous Patient-Controlled Analgesia May Inhibit Delirium Tremens

2015

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Alcoholism is common among trauma patients and often lacks the appropriate monitoring. Alcohol withdrawal syndrome (AWS), including delirium tremens (DT), can be associated with significant postoperative morbidity and mortality. However, appropriate acute pain management may protect against delirium; the administration of intravenous patient-controlled analgesia (IV - PCA) may not only alleviate pain, but also reduce the incidence of post-operative delirium. IV-PCA is widely used today; however, little attention has been paid to its influence on the development of AWS or DT post-surgery. Here we present a case in which the administration of IV-PCA may have delayed the onset of DT that interfered with postoperative care and the initiation of psychiatric consultation. The literature was reviewed to determine the potential mechanisms behind the effects of IV-PCA on the onset of AWS or DT.IV-PCA may delay the onset of DT. It is imperative to take into consideration trauma patients’ psychiatric history including answers to questions on alcoholism, so that when an IV-PCA is administered and then discontinued, adequate interventions to prevent further morbidity associated with AWS and DT can be initiated in sufficient time.

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Section: Discussionmentioning

confidence: 84%

Morphine for Intravenous Patient-Controlled Analgesia May Inhibit Delirium Tremens

2015

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Endogenous opiates: 1995

Olson

Kastin

1996

Peptides

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Pharmacotherapies for Alcohol Problems: A Review of Research with Focus on Developments since 1991

Litten¹,

Allen²,

Fertig³

1996

Alcoholism Clin & Exp Res

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Research on medications to treat alcohol problems has flourished in the last 5 years. Whereas before this time most projects focused on withdrawal agents, at least equal interest has now extended to drugs that may directly reduce urge to drink. The most promising medications in this regard are the opiate antagonists and acamprosate. Considerable attention has also been devoted to serotonergic agents. As aids to detoxification, pharmacologic agents that affect the multiple neural systems disrupted by acute alcohol withdrawal remain under active investigation. Significant progress is also being made in identifying medications to assist alcoholics suffering collateral psychopathology, especially depression and anxiety based disorders. Unfortunately, fewer gains have been realized in the development of medications to assist patients simultaneously dependent on both alcohol and illicit drugs. Also, research to develop amethystic agents remains in its very early stages.

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Opiates in Ethanol Withdrawal

Cited by 3 publications

References 20 publications

Morphine for Intravenous Patient-Controlled Analgesia May Inhibit Delirium Tremens

Morphine for Intravenous Patient-Controlled Analgesia May Inhibit Delirium Tremens

Endogenous opiates: 1995

Pharmacotherapies for Alcohol Problems: A Review of Research with Focus on Developments since 1991

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