Explaining alcohol withdrawal, thiamine, and recovery medications — CASC communication station

MRCPsych/FRANZCP-style communication station: explain AUD and withdrawal timeline, Wernicke prevention, CIWA-guided detox, naltrexone/acamprosate/disulfiram options with plain-language doses and safety, psychosocial aftercare, non-stigmatising language.

Prompt

A 44-year-old man is recovering on the medical ward after treated alcohol withdrawal. He is now oriented. His partner is present, angry that 'nobody ever warned us he could fit or go mad when he stopped'. They want to know what delirium tremens is, why thiamine injections were given, whether he is 'an alcoholic forever', and which tablets prevent relapse. He is motivated for abstinence but fearful of 'addiction-swapping' onto benzodiazepines.

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar on the ward. ^[1]

Candidate instructions. Explain alcohol withdrawal and why seizures/delirium can occur after stopping; explain thiamine (Wernicke prevention) in plain language; outline short-term benzodiazepine detox versus longer-term recovery medicines (naltrexone, acamprosate, supervised disulfiram); reduce stigma; address partner anger; agree a follow-up and safety-net plan. Check understanding. ^[2]^[3]^[4]

References5Show

[1]Connor JP, Haber PS, Hall WD Alcohol use disorders. Lancet, 2016.PMID 26343838
[2]Mayo-Smith MF Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. JAMA, 1997.PMID 9214531
[3]Caine D, Halliday GM, Kril JJ, et al. Operational criteria for the classification of chronic alcoholics: identification of Wernicke's encephalopathy. J Neurol Neurosurg Psychiatry, 1997.PMID 9010400
[4]Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry, 2018.PMID 29301420
[5]Galvin R, Bråthen G, Ivashynka A, et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol, 2010.PMID 20642790

Explaining alcohol withdrawal, thiamine, and recovery medications — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar on the ward. ^[1]

References5Show

[1]Connor JP, Haber PS, Hall WD Alcohol use disorders. Lancet, 2016.PMID 26343838
[2]Mayo-Smith MF Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. JAMA, 1997.PMID 9214531
[3]Caine D, Halliday GM, Kril JJ, et al. Operational criteria for the classification of chronic alcoholics: identification of Wernicke's encephalopathy. J Neurol Neurosurg Psychiatry, 1997.PMID 9010400
[4]Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry, 2018.PMID 29301420
[5]Galvin R, Bråthen G, Ivashynka A, et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol, 2010.PMID 20642790