The American Journal of Bioethics
ISSN: 1526-5161 (Print) 1536-0075 (Online) Journal homepage: http://www.tandfonline.com/loi/uajb20
Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder To cite this article: (2015) Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder, The American Journal of Bioethics, 15:7, 61-61, DOI: 10.1080/15265161.2015.1042716 To link to this article: http://dx.doi.org/10.1080/15265161.2015.1042716
Published online: 06 Jul 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=uajb20 Download by: [Washington University in St Louis]
Date: 07 November 2015, At: 10:11
The American Journal of Bioethics, 15(7): 61, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 1526-5161 print / 1536-0075 online DOI: 10.1080/15265161.2015.1042716
Case Summary
Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder Downloaded by [Washington University in St Louis] at 10:11 07 November 2015
CASE Mr. Jason Huggins (a pseudonym), a 38-year-old man, was admitted to a hospital orthopedic inpatient service for surgical reduction of a right femur fracture sustained in a motor vehicle crash in which he was a passenger. He had a history of drinking beer daily for more than 15 years and he smoked a half-pack of tobacco cigarettes daily. With the exception of occasional marijuana use in his teens, he denied using illicit drugs. He was not on any home medications. He had an order on his chart for 1 can of beer 3 times daily with meals, which he received from the pharmacy on his food tray with a patient label attached to the Pabst Blue Ribbon beer can. Mr. Huggins had been drinking 5–6 cans of beer daily and consumed 8–12 beers along with some liquor on weekend days for the past several years. He had a family history of addiction, and stated that his father “drank himself to death.” His previous attempts to moderate his alcohol use were unsuccessful. He did not believe treatment for alcoholism to be effective, and had not previously received formal addiction treatment for his drinking. He did receive beer with meals during a previous hospitalization. He stated that he was not interested in quitting drinking or going to an addiction treatment program. The Psychiatry Consult-Liaison service was contacted by the orthopedic service to address smoking cessation with this patient in order to improve postoperative healing of the femur fracture reduction. The psychiatrist diagnosed
Mr. Huggins with alcohol use disorder and recommended discontinuing the beer service. She argued that medications are more effective than alcoholic beverages for managing the symptoms of alcohol withdrawal before, during, and after surgery. She also viewed Mr. Huggins’s hospitalization as an opportunity to engage him in motivational interviewing, intervene in his current cycle of alcohol use and dependence, and refer him to addiction treatment. There were no specific hospital policies that governed the prescription of alcohol to surgical patients or compelled physicians to engage in screening, brief intervention, and referral to treatment (SBIRT). The orthopedic team believed that continuing the beverage service would not significantly interfere with the outcome of the surgery. They argued that Mr. Huggins’s desire to continue drinking while hospitalized should be respected. The psychiatric consultant maintained that the “duty to treat” Mr. Huggins’s underlying alcohol use disorder was more important than preserving his personal autonomy in relation to alcohol consumption. Questions for consideration: 1. Should the orthopedic team discontinue the prescription for beer? 2. To what extent should Mr. Huggins’s initial statements about his lack of interest in abstaining from alcohol or entering addiction treatment influence his surgical treatment plan? &
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ISSN: 1526-5161 (Print) 1536-0075 (Online) Journal homepage: http://www.tandfonline.com/loi/uajb20
Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder To cite this article: (2015) Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder, The American Journal of Bioethics, 15:7, 61-61, DOI: 10.1080/15265161.2015.1042716 To link to this article: http://dx.doi.org/10.1080/15265161.2015.1042716
Published online: 06 Jul 2015.
Submit your article to this journal
Article views: 87
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=uajb20 Download by: [Washington University in St Louis]
Date: 07 November 2015, At: 10:11
The American Journal of Bioethics, 15(7): 61, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 1526-5161 print / 1536-0075 online DOI: 10.1080/15265161.2015.1042716
Case Summary
Prescribing Beer for Hospitalized Patients With Alcohol Use Disorder Downloaded by [Washington University in St Louis] at 10:11 07 November 2015
CASE Mr. Jason Huggins (a pseudonym), a 38-year-old man, was admitted to a hospital orthopedic inpatient service for surgical reduction of a right femur fracture sustained in a motor vehicle crash in which he was a passenger. He had a history of drinking beer daily for more than 15 years and he smoked a half-pack of tobacco cigarettes daily. With the exception of occasional marijuana use in his teens, he denied using illicit drugs. He was not on any home medications. He had an order on his chart for 1 can of beer 3 times daily with meals, which he received from the pharmacy on his food tray with a patient label attached to the Pabst Blue Ribbon beer can. Mr. Huggins had been drinking 5–6 cans of beer daily and consumed 8–12 beers along with some liquor on weekend days for the past several years. He had a family history of addiction, and stated that his father “drank himself to death.” His previous attempts to moderate his alcohol use were unsuccessful. He did not believe treatment for alcoholism to be effective, and had not previously received formal addiction treatment for his drinking. He did receive beer with meals during a previous hospitalization. He stated that he was not interested in quitting drinking or going to an addiction treatment program. The Psychiatry Consult-Liaison service was contacted by the orthopedic service to address smoking cessation with this patient in order to improve postoperative healing of the femur fracture reduction. The psychiatrist diagnosed
Mr. Huggins with alcohol use disorder and recommended discontinuing the beer service. She argued that medications are more effective than alcoholic beverages for managing the symptoms of alcohol withdrawal before, during, and after surgery. She also viewed Mr. Huggins’s hospitalization as an opportunity to engage him in motivational interviewing, intervene in his current cycle of alcohol use and dependence, and refer him to addiction treatment. There were no specific hospital policies that governed the prescription of alcohol to surgical patients or compelled physicians to engage in screening, brief intervention, and referral to treatment (SBIRT). The orthopedic team believed that continuing the beverage service would not significantly interfere with the outcome of the surgery. They argued that Mr. Huggins’s desire to continue drinking while hospitalized should be respected. The psychiatric consultant maintained that the “duty to treat” Mr. Huggins’s underlying alcohol use disorder was more important than preserving his personal autonomy in relation to alcohol consumption. Questions for consideration: 1. Should the orthopedic team discontinue the prescription for beer? 2. To what extent should Mr. Huggins’s initial statements about his lack of interest in abstaining from alcohol or entering addiction treatment influence his surgical treatment plan? &
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