Pharmacologic management of acute abstinence syndromes

Patients addicted to alcohol and other psychoactive substances are frequently seen by family physicians. When admitted to the hospital, these patients may develop abstinence syndromes that require pharmacologic intervention. The pharmacologic management of acute abstinence syndrome from discontinuation of central nervous system depressants involves substitution of another sedative-hypnotic agent and gradual tapering of the dose over a few days. The same principle applies to opioid detoxification. Pharmacologic detoxification is generally not required in the management of abstinence syndromes involving central nervous system stimulants, cannabinoids, hallucinogens, inhalants or phencyclidine.