Step 1: Review  (Estimated Time: 20 minutes)

Read the following case study:

Daniel, a 48-year-old male, arrives at the emergency department with tremors in his extremities, profuse sweating, and marked anxiety. He appears disoriented, muttering incoherent phrases about being pursued. His medical history reveals chronic alcohol consumption for 15 years, with an abrupt attempt to quit 24 hours ago.

Daniel denies any history of epilepsy or significant comorbidities. His medical record shows three alcohol-related hospitalizations in the past five years: acute alcoholic pancreatitis (3 years ago), a fracture from falling while intoxicated (2 years ago), and treatment for severe dehydration and malnutrition (8 months ago). Previous liver tests indicate mild to moderate elevation of liver enzymes, suggesting developing liver damage without formal cirrhosis diagnosis.

He firmly denies using any other substances, including benzodiazepines, opioids, stimulants, or any recreational drugs or unprescribed medications, ruling out benzodiazepine withdrawal which presents similarly but requires different management.

Daniel has lived alone since his divorce seven years ago. He has two adult children (23 and 25) with whom he maintains sporadic contact. He works as a freelance accountant, though his job performance has steadily declined. His younger sister Maria serves as his emergency contact and reports that Daniel has attempted to quit drinking independently at least three times in the past two years without seeking professional addiction treatment.

Step 2: Respond (Estimated Time: 120 minutes)

Complete the following activities:

Step 3: Submit (Estimated Time: 10 minutes)

To share your work, click on the “"Add a new discussion topic” button and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

OPTIONAL Step 4: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”