Healthcare professionals perspectives surrounding the use of medicinal ethanol for the management of acute alcohol withdrawal in hospital settings

BACKGROUND: Alcohol withdrawal is a life-threatening complication of sudden cessation of alcohol intake in a dependent individual. Medicinal ethanol demonstrates promise in addressing the symptoms of severe alcohol withdrawal; however, its wider implementation and evaluation in acute hospital settings is limited by a lack of acceptability and feasibility data. OBJECTIVES: Review healthcare professionals' perspectives of oral ethanol prescribing for the prevention of alcohol withdrawal in an acute hospital setting. MATERIALS AND METHODS: Sandwell and West Birmingham NHS Trust is a large acute care provider in the United Kingdom; medicinal ethanol for alcohol withdrawal forms part of trust management guidelines. Health care professionals' perspectives of medicinal ethanol were reviewed by 1) a trust wide survey and 2) semi-structured interviews. Descriptive statistics and content-based analysis of survey results were performed. A qualitative descriptive approach was adopted for interview data. Discourse relating to key topics was extracted. RESULTS: Medicinal ethanol was considered a resource efficient treatment strategy. Healthcare professionals were largely advocates for the holistic and considered approach it represents for patients. Alcohol seeking behaviours, patient complaints and reputational concerns have not been an issue since its implementation. The trust alcohol care team were considered central to its success within the hospital trust. Whilst the rationale for the use of medicinal ethanol was well understood, confidence to independently prescribe remained a hurdle for healthcare professionals. CONCLUSIONS: Medicinal ethanol was considered an acceptable intervention for the prevention of severe alcohol withdrawal. Further work is required to facilitate its wider implementation in research and practice.