[Alcohol withdrawal syndrome in the hospital]

Contrary to widely held belief, physical dependency is not systematic in alcohol dependence. Alcohol withdrawal syndrome can appear even without stopping (or sharply decreasing) high or chronic alcohol intake. It occurs through revelation of a physicochemical cerebral response (membrane changes and decrease in modulation systems) to chronic intoxication. Given the differences in severity, the lability of symptoms and the rapid evolution of the syndrome, the repeated use of scales to evaluate intensity is suggested. Management should be based on this index in order to treat minor forms and to avoid a course to severe forms, which should be transferred to the intensive care unit.