Nightingale Hospitals Paris – Clinique du Château welcomes patients experiencing difficulties with alcohol for whom it has developed a dedicated programme.
There are several aspects to the problems faced by alcohol-dependent patients:
- Attempting withdrawal;
- Evaluating the patient’s mental health status, there are often signs of depression;
- Assessing any alcohol-related complications (hepatic, ENT, cognitive);
- Setting up a programme to enable the patient to remain abstinent.
Stopping drinking is not that difficult, but what can you do to not start again?
Withdrawal is usually fairly straightforward when a well-established treatment protocol is followed. However, medical treatment is required and involves a number of different specialists.
Alcohol-dependent patients are hospitalised in a specialist environment according to highly specific indications, which are different from those for withdrawal programmes in the outpatient setting. There is a precise treatment objective which is part of a therapeutic project determined at admission, based on an agreement between the patient, the doctor and the care team.
Finally, medication and psychological support together appear to be essential for ensuring successful withdrawal, in terms of tolerance and long-term abstinence.
Indications for hospitalisation of an alcohol-dependent patient:
- Hospitalisation is strongly recommended where the patient is experiencing difficulty following one or several failed attempts at withdrawal in the outpatient setting;
- Hospitalisation makes it possible for patients to remove themselves from the sometimes pathogenic surrounding environment;
- During hospitalisation, related psychiatric disorders, which are very common (depression, anxiety, personality disorder, other addictions) and requiring special treatment are looked for. Underlying somatic conditions or such conditions secondary to the patient’s alcohol dependence are also examined;
- The patient’s hospitalisation is preferable in the event of a history of seizures or withdrawal events (i.e. delirium tremens) during previous attempts.
The main objective of hospitalisation is to prevent withdrawal events. It also serves to provide pharmacological and psychotherapeutic assistance to alcohol-dependent patients. It is a chronic disease, which is often interspersed by relapses and severe somatic complications if the disease is left untreated, that can have dramatic consequences on the patient’s social, work and personal life.
The therapeutic alliance, based on the care agreement between the doctor and the patient, is the central axis around which acute but also long-term treatment of alcohol-dependent patients is based.
- The patient is admitted to the hospital following a ‘pre-admission’ consultation, during which their reasons for wanting to participate in the care programme are examined. They may also be referred by an ‘attending’ physician that knows the patient well.
- A care agreement is drawn up between the patient, the doctor and the care team (fragile patients are protected and encouraged to remain at the hospital, regular breath tests are administered, car keys handed over etc.).
- Information on alcohol addiction and therapeutic education groups are offered to patients and families of alcohol-dependent patients.
- Patients have daily individual meetings with a specialist physician (8 psychiatrists for 44 patients).
- Medication is routinely offered to ensure patient comfort during withdrawal and to prevent related complications.
Preparation for leaving the hospital involves:
- Daily meetings between the patient and their psychiatrist.
- 2 weekly meetings attended by hospitalised patients, and previously hospitalised patients. Patients can also attend following discharge to help them remain abstinent.
- Meetings between families and the doctor (with the patient’s permission).
A psychological assessment is made of the disease during hospitalisation which may mean certain specific treatments, such as antidepressants, are started.Addictions : Cannabis, cocaine, opiate, designer drugs, hypnotics, amphetamines, substance-free addiction Tobacco addiction