What does the alcohol liaison service do/offer? 

The alcohol liaison service provides a comprehensive service which includes in-patient and out-patient support with alcohol detoxification. 

A person can detox from alcohol by lowering alcohol intake gradually or all at once. It is important that this occurs in a controlled way. Medication can be a helpful part of this process. This is something you can discuss further with your nurse specialist during any consultations. 

Medication should only be taken as part of a treatment programme including attending regular treatment consultation, as agreed with your nurse specialist or doctor. 

Withdrawal symptoms 

Alcohol withdrawal symptoms occur when you become dependent on alcohol and there is no more of it in the body. Alcohol withdrawal can last 7-10 days but the process is different for everyone. 

The symptoms of alcohol withdrawal range from minor (including headaches and nausea) to moderate (including vomiting, fever and sweating) and severe. Severe alcohol withdrawal symptoms include: 

  • delirium 
  • tremors 
  • seizures 

These can lead to serious complications and can be life threatening, often leading to hospital admissions and requiring advanced pharmacotherapy. 

If you experience severe symptoms of alcohol withdrawal you should seek urgent 
medical attention and if necessary, attend A&E.

In-patient alcohol detoxification

A patient will be assessed for alcohol treatment if they are showing signs of alcohol dependency by their consultant or the medical team.  

If admitted as an in-patient to be treated for alcohol dependency, you will take part in the alcohol detoxication programme and be closely monitored for withdrawal symptoms. 

As part of your treatment, you may be given a short course of benzodiazepine to prevent withdrawal symptoms which will be reduced over four to five days. It may also be required for you to take a course of Thiamine (vitamin B1) tablets. 

Following this, you will have regular appointments with a specialist nurse. 

You may also be prescribed Oxazepam which can cause drowsiness. When taking these, you should avoid driving, operating machinery, or undertaking any task that requires being alert during this time. 

Out-patient alcohol reduction and detoxification treatments 

The out-patient clinics are currently held at the Royal Free Hospital on a Tuesday and Thursday morning and provide ambulatory alcohol detoxification. 

The out-patient clinics offer the following: 

  • Brief interventions which provide health education on the benefits of addressing alcohol use. 
  • Motivational interviewing and CBT (Cognitive Behavioural Therapy) to provide insight into individual’s alcohol dependency patterns. 
  • Prescribing medication through a Non-Medical Prescriber (NMP). The prescriber will be able to prescribe medication to reduce and achieve abstinence from alcohol. 
  • Follow-up appointments for patients in the out-patients clinic. 
  • Prescribing medication through a consultant. 
  • Prescribing medication through primary care such as GP practices and community healthcare (this is for long-term prescriptions). 
  • Comprehensive overview, which is a medical review of the patients progress at six months. 

At the out-patient clinic, we will discuss prescribing medication associated with abstinence from alcohol and the best medication(s) options for you. 

Relapse prevention medication 

Once you have started the alcohol detoxification process, you can be prescribed medication which will reduce the effects of alcohol withdrawal. It’s important to understand the process of medications prescribed post-detoxification and the way they work. 

It is important to keep to the agreed programme to ensure you benefit fully and this will result in a more positive long-term outcome for your health. 

Medications available include: 

  • Acamprosate: an anti-craving medication which reduces your desire to drink. 
  • Disulfiram: this makes drinking alcohol extremely unpleasant. 
  • Naltrexone: this reduces the pleasurable effects of alcohol. 
  • Nalmefene: this supports those struggling to reduce alcohol intake.  

These medications can be prescribed through the out-patient clinic by the NMP. A follow-up and review of the medication and how you are coping will be conducted at clinic appointments. These will be initially every two weeks and then based on your need. 

You will be given information of how each medication works and their side effects. This will also be included with the medication. 

It is important before making any decisions about medication that you discuss this with your nurse specialist, and it is part of an ongoing intervention. You must give an accurate alcohol and substance misuse history and should report any underlying psychiatric illnesses or thoughts of self-harm. 

Risks and side-effects of medication 

Some medication is not suitable for people with certain conditions or may only be used if extra care is taken. For these reasons, before you start medication you should make sure that the prescribing clinician is aware of your full medical history, your current medication, including over the counter medication, and if you’ve had any previous allergic reactions to medication. 

Most medication can cause unwanted side effects, though not everyone will experience them. Any side effects will often improve as your body gets used to the new medicine, but you must speak to a member of the alcohol team or your doctor if they persist or become troublesome. 

If you are struggling with serious side effects, call 999 in an emergency or go to A&E.