Use of alcoholic beverages in VA medical centers

Abstract

Background: Benzodiazepines are the first-line choice for the treatment of alcohol withdrawal syndrome. However, several hospitals continue to provide alcoholic beverages through their formulary for the treatment of alcohol withdrawal. While there are data on the prevalence of this practice in academic medical centers, there are no data on the availability of alcoholic beverages at the formularies of the hospitals operated by the department of Veteran's Affairs.

Implementing managed alcohol programs in hospital settings: A review of academic and grey literature

“…Additional gaps in the literature exist. Although evidence herein clearly indicates that in some cases hospital staff are willing to dispense alcohol to patients, several studies [44,50,51,53,[55][56][57]62,[67][68][69]71] noted potential reluctance, which could result from personal, ethical, or religious beliefs. Possible opposition could also occur at the institutional level, particularly when hospitals are faith-based or when MAPs conflict with risk management or safety policies.…”

“…Several hospital studies noted concerns regarding sending conflicting messages of the detrimental effects of alcohol use to patients. To mitigate this concern, the beverage alcohol could be dispensed in a medicine bottle, as was the procedure in one hospital study , and the patient could be monitored while consuming the alcohol, as is standard protocol in community MAPs.…”

“…Five studies conducted cross-sectional surveys of hospital administrators to examine trends in the provision of alcohol to inpatients, four in the USA [67][68][69][70] and one in the UK [71]. All found strong evidence that IV alcohol was dispensed to treat or prevent AWS while beverage alcohol was dispensed to both treat and prevent AWS but also for patient amenity, sedation or other reasons [67][68][69][70][71]. All five surveys found that beer was the most commonly dispensed beverage alcohol, followed by spirits [67,[69][70][71], wine [67,69,70], and brandy/sherry [67,70,71].…”

“…All found strong evidence that IV alcohol was dispensed to treat or prevent AWS while beverage alcohol was dispensed to both treat and prevent AWS but also for patient amenity, sedation or other reasons [67][68][69][70][71]. All five surveys found that beer was the most commonly dispensed beverage alcohol, followed by spirits [67,[69][70][71], wine [67,69,70], and brandy/sherry [67,70,71]. Beverage alcohol was generally prescribed by physicians, procured by the pharmacy or food services, and administered by nurses.…”

“…This study paired beverage alcohol with benzodiazepine administration and only mentioned pregnancy as an exclusion criterion [44]. Finally, although several hospital studies [44,50,51,53,[55][56][57]62,[67][68][69]71] mentioned possible ethical dilemmas or hesitancy on the part of hospital staff to administer alcohol to patients, none examined these potential barriers in detail.…”