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Alcohol Withdrawal

Sebastian T. Tong, MD, MPH Reviewed 06/2019
 


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 patien...

REFERENCES

1
Moyer VA; for Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. Preventive Services Task Force recommendation...

ADDITIONAL READING

  • Muncie HLJr, Yasinian Y, Oge’ L. Outpatient management of alcohol withdrawal syndrome. Am Fam Physician.  2013;88(9):589–595. [View Abstract on OvidMedline]

  • Sarff M, Gold JA. Al...

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 maintains a “light somnolence” (e.g., sleeping but easily arousable), and should be tapered off carefully even after ...

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