Alcohol Withdrawal

Robert A. Baldor, MD, FAAFP Reviewed 06/2017
 


BASICS

DESCRIPTION

Alcohol withdrawal syndrome (AWS) is a spectrum of symptoms that results from abrupt cessation of alcohol in a dependent patient. Symptoms can begin within 5 hours of the last drink ...

DIAGNOSIS

  • Diagnostic and Statistical Manual of Mental Disorders AWS criteria are diagnosed when ≥2 of the following present within a few hours to several days after the cessation or reduction of heavy...

TREATMENT

The goal is to prevent and treat withdrawal symptoms (e.g., seizures, DTs, cardiovascular events). This is done primarily with BZDs, which reduce the duration of symptoms and raise the seizu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Discharge arrangements include transfer to a treatment facility (e.g., sober house or residential program), outpatient substance abuse counseling, peer support gr...

REFERENCES

Moyer  VA. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med.  2...

ADDITIONAL READING

Sarff M, Gold JA. Alcohol withdrawal syndromes in the intensive care unit. Crit Care Med.  2010;38(9) (Suppl):S494–S501.  

SEE ALSO

Substance Use Disorders 

CODES

ICD10

  • F10.239 Alcohol dependence with withdrawal, unspecified

  • F10.230 Alcohol dependence with withdrawal, uncomplicated

  • F10.231 Alcohol dependence with withdrawal delirium

  • F10.232 Alcohol dependence...

CLINICAL PEARLS

  • Any BZD dose should be patient-specific, sufficient to achieve and maintain a “light somnolence” (e.g., sleeping but easily arousable) and should be tapered off carefully even after AW...

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