A 52 years old male was admitted in my ward presenting acute confusion from GHB drug withdrawal, had a fall at home resulting in humeral fracture. Before rendering care to him, I introduced myself, gained consent and maintained privacy and dignity all through. The patient appeared agitated and unsettled when the shift started, and was assigned enhanced care where he had one to one care. Patient was presenting symptoms of confusion, hallucination and was sweaty and tremulous. Patient was on an hourly CIWA score to assess and manage his withdrawal symptoms. During the CIWA assessment, factors such as the patients anxiety, nausea and tremors were evaluated to guide treatments of his undergoing drug detoxification. Patient had a prescription of diazepam with a start dose of 10mg. In the morning he was administered with 10mg dosage of diazepam. Under supervision, on one of the hourly rounds of his CIWA assessments, I asked patient if he was aware of his environment. He seemed confused at that point as he was not sure of his environment. I asked patient if he knew the date and day, his response was negative as he gave me a wrong date and day. Patients mouth appeared dry so I offered him water but he seemed drowsy and unresponsive. The staff nurse and I started calling out his name loudly with no response. The emergency bell was immediately pressed to alert doctors and all staff members. Patient was put on a high flow oxygen 10L via non-rebreathe mask and he was saturating at 100%. I quickly observed his vital signs and monitored it. Patients vital were within range. I undertook patients blood glucose levels and it read 5.7mmol/L which was within patients range. Patient became responsive, alert and started talking. Patients observations were rechecked fifteen minutes after and were within range. Patient was assessed and reviewed by doctors and the DASS team. ECG was done and results reported to the doctor.

I understood the CIWA assessment tool as I was able to evaluate the patient by assessing the severity of GHB withdrawal symptoms. I learnt that a patient scoring between 0-8 meant minimal to no withdrawal, 9-15 meant mild withdrawal and close monitoring will be needed. Scoring between 16-21 meant moderate withdrawal and interventions and referral may be required. Scoring above 21 meant severe withdrawal and medical intervention will be needed. Understanding the scoring scale help to know what interventions to give patients in managing the addictions.