Alcohol Withdrawal

Sebastian Tong, MD, MPH Reviewed 06/2018

BASICS

DESCRIPTION

Alcohol withdrawal syndrome (AWS) is a spectrum of symptoms that results from abrupt cessation or reduction in alcohol intake, which has previously been heavy or prolonged. Symptoms ...

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

GENERAL MEASURES

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...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Managing alcohol withdrawal is only first step toward treating patient’s underlying AUD.
Discharge arrangements should include:
- Development of plan to engage pati...

REFERENCES

Moyer VA; for the Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. Preventive Services Task Force recommenda...

ADDITIONAL READING

Ricks JI, Replogle WH, Cook NJ. FPIN’s clinical inquiries. Management of alcohol withdrawal syndrome. Am Fam Physician. 2010;82(4):344–347. [View Abstract on OvidMedline]
Sarf...

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 A...

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