Alcohol-use disorders: diagnosis and management of physical complications

Context

In the UK, it is estimated that 24% of adults drink in a hazardous or harmful way (NHS Digital Statistics on alcohol: England, 2009) For definitions of harmful and hazardous drinking see terms used in this guideline. Levels of self-reported hazardous and harmful drinking are lowest in the central and eastern regions of England (21 to 24% of men and 10 to 14% of women). They are highest in the North East, North West and Yorkshire and Humber (26 to 28% of men, 16 to 18% of women; North West Public Health Observatory, 2007). 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 (Royal College of Physicians (2001) Alcohol – can the NHS afford it?).

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):

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.

In the current update, we reviewed the evidence and updated the recommendation on corticosteroid treatment for people with severe alcoholic hepatitis.