Open ward management of acute alcoholism; experience with a pilot program.

Sixty acutely alcoholic patients were treated in unsegregated rooms of two to twelve beds in a general hospital to determine the feasibility of open ward care. Personnel caring for them were first educated in the nature of alcoholism, the aberrations it produces and treatment with tranquilizing drugs. Fears and objections were overcome. Violent or unpredictable patients were excluded from the test, but those with alcoholic hallucinations or delirium suspectible to control were admitted. Preliminary physical examination was done to find out whether there was coincidental disease. In three patients, one with subarachnoid hemorrhage, one with severe anemia and one with pneumonia and shock, this examination followed by prompt treatment was probably life-saving. Tranquilizers, fluids and vitamins were given routinely, by mouth as soon as possible. Alcoholic patients were found to be no more unmanageable than others. If it were generally accepted that acutely alcoholic patients, diagnosed as such, could be admitted to open ward care in general hospitals, candor in diagnosis would be encouraged thereby, coincident disease probably would be promptly recognized if present, and long-term treatment for the alcoholic addiction could be begun early.