ABSTRACT
INTRODUCTION: Acute alcoholic intoxications (AAI) are frequent in hospitals. This entails some difficulties to caregivers and their clinical approach is little developed in France. This study aimed at estimating perception of alcohol consumption of hospitalized people with positive alcohol blood test at admission. Alcohol measurements were nonsystematic and ordered by a physician. Then this study assessed the role of a clinical interview the day after an AAI. METHODS: Each person admitted with a positive alcohol blood test was systematically met by a professional in addictology, referring to a procedure in process for 10 years in this hospital. A prospective collection of the data was performed during 2006. RESULTS: Nine hundred and seventy-three episodes were identified corresponding to 758 persons (78% of men and 22% of women). The average alcohol blood level was 2.06+/-1.18g/L. Eighty-five percent of those patients were admitted and 52% were interviewed. Damage due to alcohol was identified for 69% and a misuse of alcohol for 92% (19% abuse, 73% dependence according to the DSM IV), without significant correlation to alcohol blood level. CONCLUSION: Blood alcohol level assay at the hospital admission, when the test has been medically recommended, targets a misusing alcohol group of people. These patients need addictologic care, after a first toxicological stage. This study confirms that in such a case a discussion offer is possible and agreed by diseased people. This offer is a first step towards people who could not express explicitly their need for help and constitute an opportunity to care.
Subject(s)
Alcoholic Intoxication/epidemiology , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Alcohol Drinking/psychology , Alcoholic Intoxication/pathology , Alcoholic Intoxication/psychology , Alcoholism/epidemiology , Child , Ethanol/blood , Female , France/epidemiology , Hospitalization , Hospitals, General , Humans , Male , Middle Aged , Perception , Sex Ratio , Young AdultABSTRACT
The authors relate a single case of fluoxetine misuse of a 31-year-old woman, with a previous history of multi drug addiction, and who weaned of all illicit substance and alcohol intake for several months. From a medical fluoxetine prescription at a dose of 20 mg per day, the patient increased to 280 mg per day within few months. Tolerance and dependency to the substance (according to DSM IV) and withdrawal syndrome occurred following fluoxetine discontinuation. This misuse keeps on for more than one year, and no symptom of a "serotonin syndrome" has ever been found. In our understanding, this exceptional case-report seems to be the first one related either in medical literature or drug monitoring centers.
