Treatment of alcohol withdrawal in hospitalized patients

Alcoholism can be encountered in many aspects of medicine. Frequently, primary-care physicians are asked to treat patients who are experiencing various stages of alcohol withdrawal while hospitalized for intercurrent illness. A thorough assessment of the patient is important because the symptoms and signs of alcohol withdrawal are nonspecific. Recognizing the patient who is at risk for alcohol withdrawal and initiating appropriate treatment can prevent progression to more serious symptoms and complications. Benzodiazepines are the drugs of choice for pharmacologic treatment of alcohol withdrawal. Their application by means of a symptom-triggered approach based on frequent, objective assessment of the patient is recommended. Adjunctive therapy for specific complications of alcohol withdrawal is discussed. After the acute withdrawal symptoms have been controlled, psychiatric or chemical dependence assessment (or both) is strongly encouraged.