The Curbsiders Internal Medicine Podcast7 Touko 2020

#212 Inpatient Alcohol Withdrawal: Sober Talk with Joji Suzuki, MD

Crush those 11 pm “STAT: Patient agitated” pages with this expert guide to assessing for and treating alcohol withdrawal! Dr. Joji Suzuki MD, addiction psychiatrist extraordinaire at the Brigham and Women’s Hospital, walks us through how to think about the risk of severe withdrawal, the different ways to manage it, and how to engage with patients as they’re leaving the hospital. In the course of this Car-Talk (well, not exactly the same as the critically acclaimed radio show, but he did record in his car….), Dr. Suzuki demystifies withdrawal and debunks some common myths: that we must manage withdrawal inpatient, that banana bags are the cure to a hangover and alcoholic malnutrition, and that we tend to under-medicate with benzos (actually, it’s the opposite!).

Credits

Written and Produced by Nora Taranto MD
Infographic and Cover Art by: Nora Taranto MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Cyrus Askin MD, Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Guest: Joji Suzuki MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
02:52 Guest one-liner; Career advice; Picks of the Week*: Why We Do What We Do (book); Fargo (film)
08:10 A Case from Kashlak and Screening for Alcohol Use and Severe Withdrawal Risk
17:32 Outpatient Versus Inpatient Treatment
25:27 Gabapentin for alcohol withdrawal
27:10 Indicators for ICU level Care
31:53 Symptom-Driven versus Fixed-Dose Protocols , Benzos vs. Barbs
36:55 And which benzo?
39:47 A Natural History of Withdrawal
44:10 Banana Bags and Thiamine Deficiency
48:17 The Transition Home: Naltrexone, Bridge Clinics, and Motivational Interviewing
56:36 Outro and Bonus clip

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