Impact of an Alcohol-based hand sanitizer usage during COVID-19 pandemic on disulfiram treatment: A South Indian psychiatrist's practice experiences
Keywords:Alcohol-Based Hand Sanitizer, Addiction, COVID-19, Disulfiram-Ethanol Reaction (DER)
Background: Alcohol-based hand sanitizer (ABHS) usage has become one of the COVID-19 pandemic-related adapted responses. Some disulfiram-ethanol reactions are reported in people who use alcohol-based hand rub/sanitizer and take Disulfiram as a treatment for their alcohol use disorders. Aim & Objective: To determine the practice experiences of psychiatrists on disulfiram prescription to alcohol use disorder victims. Methodology: A cross-sectional study on the psychiatrists to find the experiences of disulfiram prescription to their clients with alcohol use disorders during the COVID-19 pandemic. Results: Nearly 84 (51%) were reverted with a completed questionnaire. Among the respondents, 28 (33.3%) of the respondents decreased to prescribe Disulfiram, 48 (57.1%) reported that their patients stopped using ABHS due to fear of Disulfiram-Ethanol Reaction (DER), and 20 (23.8%) responders notified that their patients were expressed their worry on DER with Disulfiram and ABHS. Conclusion: Disulfiram prescribed for alcohol use disorders; treatment got peculiar experiences with the incidences of DER reported with Alcohol-based hand sanitizer. Many practitioners were scared to prescribe disulfiram due to DER with ABHS. The prevailing evidence that there is no possibility of cutaneous application of ABHS producing enough significant DER. Hence using ABHS is not a contraindication for disulfiram prescription.
Ganesh S, Kandasamy A, Sahayaraj US, Benegal V. Adult Attention Deficit Hyperactivity Disorder in Patients with Substance Use Disorders: A Study from Southern India. Indian J Psychol Med. 2017;39(1):59-62.
Mutschler J, Grosshans M, Soyka M, Rösner S. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence. Pharmacopsychiatry. 2016;49(4):137-41.
Wang SC, Chen YC, Lee CH, Cheng CM. Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. Int J Mol Sci. 2019;20(17):4294.
Raos N, Martin DF, Martin BB, Alldredge R, Rasmussen SC, Kraft A, et al. Reviews 112 call for nominations for the 2009 edelstein award 125 instructions for authors 126 Bull. Hist Chem. 2008;33(2).
Harada S, Agarwal DP, Goedde HW. Mechanism of alcohol sensitivity and disulfiram-ethanol reaction. Subst Alcohol Actions Misuse. 1982;3(1–2):107–15.
Elenbaas RM. Drug therapy reviews: management of the disulfiram alcohol reaction. Am J Hosp Pharm. 1977;34(8):827–31.
Newton-Howes G, Levack WMM, McBride S, Gilmor M, Tester R. Non-physiological mechanisms influencing disulfiram treatment of alcohol use disorder: A grounded theory study. Drug Alcohol Depend [Internet]. 2016;165:126–31.
Mason BJ, Heyser CJ. Alcohol Use Disorder: The Role of Medication in Recovery. Alcohol Res. 2021;41(1):07.
Kratzel A, Kratzel A, Todt D, V'kovski P, Steiner S, Steiner S, et al. Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 by WHO-Recommended Hand Rub Formulations and Alcohols. Emerg Infect Dis. 2020;26(7):1592–5.
Singh D, Joshi K, Samuel A, Patra J, Mahindroo N. Alcohol-based hand sanitisers as first line of defence against SARS-CoV-2: a review of biology, chemistry and formulations. Epidemiol Infect. 2020;148:e229.
De Sousa A. Disulfiram Ethanol Reaction in a Patient Abstinent from Alcohol Caused by Hand Sanitizing. Alcohol Alcohol. 2020;55(4):349.
Haddock NF, Wilkin JK. Cutaneous reactions to lower aliphatic alcohols before and during disulfiram therapy.Arch Dermatol.1982;118(3):157-9
Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol. 2002;23(S12):S3–40.
Jorgensen CH, Pedersen B, Tønnesen H. The efficacy of Disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35(10):1749–58.
Stokes M, Abdijadid S. Disulfiram. [Updated 2022 Oct 24]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-Available from: https://www.ncbi.nlm.nih.gov/books/NBK459340/
Brewer C, Streel E. Is Alcohol in Hand Sanitizers Absorbed Through the Skin or Lungs? Implications for Disulfiram Treatment. Alcohol Alcohol. 2020;55(4):354-356.
Ghosh A, Mahintamani T, Balhara YPS, Roub FE, Basu D, Bn S, Mattoo SK, Mishra E, Sharma B. Disulfiram Ethanol Reaction with Alcohol-Based Hand Sanitizer: An Exploratory Study. Alcohol. 2021;56(1):42-46.
Disulfiram: Uses, Dosage, Side Effects & Warnings. Drugs.com. [cited 2022 Dec 19]. Available from: https://www.drugs.com/disulfiram.html
Samhsa. Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. [cited 2022 Dec 15]; Available from: http://store.samhsa.gov.
Brewer C. How effective is the standard dose of disulfiram? A review of the alcohol-disulfiram reaction in practice. Br J Psychiatry. 1984;144:200-2.
Kaner EF, Beyer FR, Muirhead C, Campbell F, Pienaar ED, Bertholet N, Daeppen JB, Saunders JB, Burnand B. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018;2(2):CD004148.
Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9(2):e87366.
Skinner MD, Coudert M, Berlin I, Passeri E, Michel L, Aubin HJ. Effect of the threat of a disulfiram-ethanol reaction on cue reactivity in alcoholics. Drug Alcohol Depend. 2010;112(3):239-46.
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Copyright (c) 2022 Naveen Kumar Dhagudu, Pallavi Madithati, Gouthami B, Bayapa Reddy Narapureddy, Mayurnath Reddy Jelly, Sathish Attili, Khursheed Muzammil, Nazim Nasir, Kalyan viswanath Reddy Lingala
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