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The Curbsiders Internal Medicine Podcast

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

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.83.1K Ratings

🗓️ 7 May 2020

⏱️ 58 minutes

🧾️ Download transcript

Summary

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

Transcript

Click on a timestamp to play from that location

0:00.0

The Curbsiders podcast is for entertainment, education, and information purposes only.

0:07.0

And the topics discussed should not be used solely to die in a street, you're or prevent

0:09.4

any diseases or conditions.

0:10.4

For the more that you use, and say, and express on this podcast are solely those of those,

0:12.2

and should not be interpreted to reflect the official policy or position of gaining

0:14.2

entity aside from possibly, cash like more hospital and affiliate outreach programs.

0:16.8

If indeed, there are any, in fact, there are none.

0:18.6

Pretty much we aren't responsible if you screw up, you should always do your own homework

0:20.5

and let us know when we're wrong.

0:31.0

Well, Paul, this was a really good one.

0:35.0

I'm really excited to get to the show.

0:36.3

Of course, we're talking about the inpatient side of alcohol use disorder specifically

0:40.9

withdrawal.

0:42.4

And we had a great guest tonight.

0:44.4

This is the Curbsiders.

0:45.4

Paul, can you tell people what do we do on this show?

0:48.4

Well, of course, Matt, we are the internal medicine podcast.

0:51.6

We use expert interviews to renew clinical pearls and practice changing knowledge.

0:54.8

And this is a great one.

0:57.0

The great Dr. Norah Toronto has brought us an outstanding guest to talk to us about

1:01.4

the management of inpatient alcohol withdrawal.

1:03.8

So Nora, what did we learn?

...

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