Improving quality through the development of a benzodiazapine sparing protocol for treating alcohol withdrawal in a community correctional setting

Abstract

Alcohol detoxification within community correctional environments poses significant challenges to local jurisdictions that are called to manage rising rates of incarceration among citizens with complex health needs including multiple comorbidities and mental illness and substance abuse. Traditional methods for intervening during detoxification have relied upon benzodiazepine tapers to reduce chances of the most serious consequences of alcohol withdrawal syndrome (AWS) but these medications have been increasingly attributed to poor outcomes such as increased risks of delirium, medication interactions, and risk of diversion among others. This project describes an evidence-based benzodiazepine sparing protocol that can be used to avoid use of this class of medications as well as an associated education intervention for detention officers and healthcare staff in one community correctional institution designed to improve knowledge of monitoring and treatment for inmates suffering from AWS. In total, 28 staff participated in the training and results suggest excellent overall quality and accomplishment of objectives at a high level. Implications for advanced practice nursing are discussed as well as directions for future dissemination efforts for BZ-sparing treatment.