Alcohol Dependence

My patient looked at me one morning with a questioning look in her eye and wanted to talk about what had happened during her hospitalization. I was wondering how much she really wanted to hear, so I started slowly to gauge her reactions and tread very carefully with my terminology. I avoided the term alcoholic and instead used alcohol dependence. It just has a nicer, less-pointing-finger sound do it.

She was shocked to hear that the amount of alcohol she drank each day (3-4 glasses of wine) had an effect on her that caused her to go into DT's (Delirium Tremens) after surgery when her body wasn't getting the alcohol it was used to and needed. I then went on to explain how it could be dangerous and how we treat it with a drug called Ativan. She was shocked to hear that so much had gone on as she doesn't remember much about her time in the ICU. What she does remember she described it like being part of the movie "Invasion of the Body Snatchers."

At this point it is always so tricky, because you know they are a serious alcoholic, and that they have not a clue as to how much they are hurting themselves. It's a difficult conversation to have as you want to keep them from becoming defensive but you want to be honest with them. I was more than caught off guard when the patient told me that she never wanted to go through anything like that again. I took it as a chance to tell her that the withdrawal period was awful and that we had helped her get through it. Now came the time when she had to decide how she was going to live her life once she got home.

I started on the route of the drinking in moderation talk, the one where you let them know that they have to cut down or stop without going anywhere near those judging statements. In the end it was her who called me out and said, "Wouldn't it be better if I just stopped altogether?" I was blown away. I immediately offered to get her information, and when her husband came in I explained to him all that we had just discussed. It was the closest thing to an intervention that I have ever been involved with, and I with her the best of luck in her new sobriety.