Alcohol-use disorders: Diagnosis and clinical management of alcohol-related physical complications
This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/cg100
In the UK, it is estimated that 24% of adults drink in a hazardous or harmful way (for definitions of harmful and hazardous drinking see page 7). Levels of self-reported hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the North East, North West and Yorkshire and Humber (26–28% of men, 16–18% of women). Hazardous and harmful drinking are commonly encountered among hospital attendees; approximately 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels.
Continued hazardous and harmful drinking can result in alcohol dependence. An abrupt reduction in alcohol intake in a person who has been drinking excessively for a prolonged period of time may result in the development of an alcohol withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can result in damage to almost every organ or system of the body.
This guideline covers key areas in the investigation and management of the following alcohol-related conditions in adults and young people (aged 10 years and older):
acute alcohol withdrawal, including seizures and delirium tremens
acute and chronic pancreatitis.
It does not specifically look at women who are pregnant, children younger than 10 years, or people with physical or mental health conditions caused by alcohol use, other than those listed above.
This is one of three pieces of NICE guidance addressing alcohol-related problems among people aged 10 years and older. The others are:
'Alcohol-use disorders: preventing the development of hazardous and harmful drinking' NICE public health guidance 24 (2010). Public health guidance on the price, advertising and availability of alcohol, how best to detect alcohol misuse in and outside primary care, and brief interventions to manage it in these settings.
'Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence' NICE clinical guideline 115 (2011). A clinical guideline covering identification, assessment, pharmacological and psychological/psychosocial interventions, and the prevention and management of neuropsychiatric complications.
The guideline will assume that prescribers will use a drug's summary of product characteristics to inform decisions made with individual patients. This guideline recommends some drugs for indications for which they do not have a UK marketing authorisation at the date of publication, if there is good evidence to support that use. Where recommendations have been made for the use of drugs outside their licensed indications ('off-label use'), these drugs are marked with a footnote.
 The NHS Information Centre (2009) Statistics on alcohol: England. Leeds: The Health and Social Care Information Centre
 North West Public Health Observatory (2007) Indications of public health in the English Regions 8: alcohol. Liverpool: Association of Public Health Observatories
 Royal College of Physicians (2001) Alcohol - can the NHS afford it? Recommendations for a coherent alcohol strategy for hospitals. London: Royal College of Physicians