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

The Curbsiders Internal Medicine Podcast

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!).

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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