Today’s topic is the management of acute alcohol withdrawal. On our last episode #10 from December 2017, we covered alcohol use disorder, including evaluation and management of this condition. Please review episode 10 for more information on alcohol use disorder. Today we will discuss epidemiology, DSM5 criteria, etiology, evaluation, clinical course and treatment of acute alcohol withdrawal.
As previously discussed in episode 10, in the US the 12-month prevalence of AUD is estimated to be 4.6% in teenagers and 8.5% in adults. However, the prevalence of AUD in hospitalized patients is estimated to be as high as 40%, with about half of patients with AUD experiencing alcohol withdrawal with reduction or cessation of alcohol use. Most individuals do not experience significant withdrawal symptoms; however, withdrawal is common within the emergency departments and medical and surgical inpatient units. While most alcohol withdrawal is mild, an estimated 10-20% of patients will experience more severe withdrawal symptoms including hallucinosis, seizures, and delirium tremens. These can be a reason for admission to inpatient hospitalization as well.
- Sadock, Benjamin James. Sadock, Virginia Alcott. Ruiz, Pedro. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/clinical Psychiatry. Philadelphia: Lippincott Williams & Wilkins, 2015. Print.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington: American Psychiatric, 2014. Print.
- Pace, Christine MD. “Alcohol withdrawal: Epidemiology, clinical manifestations, course, assessment, and diagnosis.” UpToDate, 20 July 2017. Web. 16 January 2018.
- Hoffman, Robert S, Gearld L Weinhouse MD. “Management of moderate and severe alcohol withdrawal syndromes.” UpToDate, 27 September 2017. Web. 16 January 2018.