Alcohol withdrawal

Summary of changes

Medicines 

  • Clarification on benzodiazepines doses
  • Diazapam tapered over 3 days (was 2-3 days)
  • IV/IM thiamine dose adjusted to daily for first 3 days and increased from 200mg to 300mg

Other

  • Red fag box moved upfront
  • The final section of CIWA on orientation has been modified to be more appropriate for people from remote communities

Primary references

  1. Expert Groups for Psychotropic, version 7 (2013) Alcohol and other drug problems, Therapeutic Guidelines, accessed 11 January 2022.

  2. Saunders JB, Conigrave KM, Latt NC, Nutt DJ, Marshall J, Ling W, and Higuchi S (2016) Addiction medicine, 2nd edition, Oxford Specialist handbooks, UK.

  3. Schuckit MA (2014) 'Recognition and management of withdrawal delirium (delirium tremens)', New England Journal of Medicine, 371(22):2109-13, doi:10.1056/NEJMra1407298

  4. South Australian Health, Government of South Australia (2016) Clinical Guideline Management of patients at risk of alcohol withdrawal in acute hospitals, Clinical Guideline, accessed 24 April 2022.

  5. Sullivan JT, Sykora K, Schneiderman J, Naranjo CA and Sellers EM (1989) 'Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)', British Journal of Addiction, 84(11):1353-7, doi:10.1111/j.1360-0443.1989.tb00737.x