Introduction
According to the case study, a 54-year-old man has severe alcohol withdrawal symptoms and needs special care. Based on the information received, a comprehensive, thorough analysis of the patient’s situation within the American Society for Addiction Medicine (ASAM) Criteria is necessary. This set of criteria is required to accurately assess a person’s condition and determine the most appropriate care and treatment. Conducting a detailed study that appeals to the main ASAM concepts will determine the importance of placing the client at a proper level of care.
Analysis
The decision’s accuracy and objectivity regarding the patient’s situation require reviewing several ASAM Criteria. Subsequently, these criteria should be correlated with the man’s examination results and reports. These criteria are based on a multidimensional approach to examining the patient’s biological, emotional, and social needs (Walker & Sharp, 2023). Consequently, they will help determine the best level of treatment for acute altered mental status due to alcohol withdrawal.
Dimension 1: Acute Intoxication and/or Withdrawal Potential
The patient presented to the emergency department with signs of alcohol withdrawal syndrome (AWS) with a previous alcohol use disorder (AUD). AWS is one of the most life-threatening illnesses, especially for seizures or delirium tremens, which, in addition to glutamate overactivity, can lead to Gayet–Wernicke syndrome (Airagnes et al., 2019). It is essential to pay attention to such aspects and take preventive measures.
Furthermore, the man decided to stop drinking alcohol for about 10 hours before going to the medical facility. Until then, he had been able to consume 0.5 to 1 gallon of vodka daily, but with lengthy interruptions. Eight years ago, he abstained from alcohol for seven years.
Dimension 2: Biomedical Conditions and Complications
In childhood, the patient had undergone umbilical hernia repair, seizure disorder, hypertension, and glaucoma. From the age of 18, he suffered from addictive disorders from smoking illegal substances, which developed over time and became chronic and recurrent. In addition, he had delirium tremens and withdrawal seizures in his youth, even though he abstained from alcohol.
The client reported frequent loss of consciousness recently, indicating central nervous system abnormalities seen at a younger age. Currently, the patient is most concerned about head, abdomen, and chest pains and visual and auditory hallucinations. The man has tongue lacerations, chills, fever, general weakness, and malaise.
Dimension 3: Emotional, Behavioral, and Cognitive Conditions and Complications
The patient simultaneously has emotional and cognitive conditions that must be addressed, as they complicate proper care and treatment. The client is in the first phase of shock because he is excited, frightened, discouraged, and scared due to the situation that happened to him outside. At the same time, he feels weak and tired; it is difficult to breathe and think because of pain in his chest, stomach, and head. In a state of confusion, the patient loses the ability to communicate productively, comprehend what he perceives, and express it in correct, precise, logical speech. The man has difficulty navigating the situation and environment due to visual and auditory hallucinations.
Dimension 4: Readiness to Change
By seeking help from medical professionals, the patient is willing to change his behavior. In this case, the client sees the problem and is ready to treat existing ailments comprehensively. Nevertheless, the man’s readiness and consent to accept treatment and eradicate the harmful habit should be discussed with him to confirm these conclusions. There are risks that the patient will refuse treatment, as happened when he left an addiction treatment program in a residential clinical stabilization service four days before admission to the hospital. The interview will allow a clinician to understand the patient’s readiness for change, motivation, feelings, emotions, and attitudes.
Dimension 5: Relapse, Continued Use, or Continued Problem Potential
The man is in potential danger since he may have a second seizure due to abrupt withdrawal from alcohol. Analysis of the anamnesis demonstrates that the person’s propensity for alcoholism, drug addiction, and lack of knowledge and skills to cope effectively with addictions can affect the likelihood of relapse. A thorough patient examination is necessary since he risks developing AWS and several other serious diseases related to the nervous system, brain function, intestines, stomach, liver, bladder, lungs, body temperature, and more.
Dimension 6: Recovery/Living Environment
Without any doubt, the life situation and social circle can interfere with the patient’s efforts on the way to recovery. The family history shows the client’s mother, father, and two brothers have AUD. Moreover, the man lived for a long time as a homeless person and did not have the means for a whole existence and life. Problems in the family and the hardships of life could become the main factors in the patient’s addiction formation.
Discussion
Based on the above details, patient care is recommended at a minimum Level of 3.5. The client is at risk of imminent harm from AWS and should receive inpatient treatment under 24-hour supervision. Inpatient treatment is crucial to avoid future adverse consequences, leading to serious complications and death. In this case, the patient will be comfortable and safe, allowing him to recover sooner.
Conclusion
Following the case information and ASAM criteria, it is essential to place the client in the 3.5 level of care. The patient is in critical condition and needs exceptional support under the supervision of medical specialists. This data is reported by the man’s words and the analysis of his and his family’s anamnesis. It is essential to leave the client in the hospital for inpatient treatment and prevent adverse consequences in advance.
References
Airagnes, G., Ducoutumany, G., Laffy-Beaufils, B., Le Faou, A. L., & Limosin, F. (2019). Alcohol withdrawal syndrome management: Is there anything new?. La Revue de Médecine Interne, 40(6), 373-379. Web.
Walker, L.K., & Sharp, A. (2023). ASAM criteria & levels of care in addiction treatment. American Addiction Centers. Web.