ASAM Pocket Guidelines and Patient Guide

Alcohol Withdrawal Management

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Disclaimer is document attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. is document should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations A2AA, Alpha-2 adrenergic agonists; AUDIT-PC, alcohol use disorder identification test – primary care; ASAM, American Society of Addiction Medicine; ASSIST, alcohol, smoking and substance involvement screening test; AUD, alcohol use disorder; BAC, blood alcohol concentration or content; BAWS, brief alcohol withdrawal scale; BZD, benzodiazepine; CAB, carbamazepine; CCU, cardiac/coronary care unit; CIWA-Ar, clinical institute withdrawal assessment for alcohol, revised; CNS, central nervous system; DSM-5, diagnostic and statistical manual – 5; ED, emergency department; FAS, fetal alcohol syndrome; FASD, fetal alcohol spectrum disorders; FDA, Food and Drug Administration; GAB, gabapentin; GABA, gamma-aminobutyric acid, or γ-aminobutyric acid; GAD-7, generalized anxiety disorder test – 7; ICU, intensive care unit; IM, intramuscular; IPRAS, interpercentile range adjusted for symmetry; IV, intravenous; LARS, Luebeck alcohol-withdrawal risk scale; No Rx, no medication (supportive care alone), PAWSS, prediction of alcohol withdrawal severity scale; PB, phenobarbital; PHQ-9, Patient Health Questionnaire – 9; PO, by mouth; SAMHSA, Substance Abuse and Mental Health Services Administration; SAWS, short alcohol withdrawal scale; SUD, substance use disorder; WM, withdrawal management ASAM Guideline on Alcohol Withdrawal Management Committee Anika Alvanzo, MD, MS, DFASAM, FACP; Ken Freedman, MD, MS, MBA (Chair of ASAM Quality Improvement Council); Kurt Kleinschmidt, MD, FASAM; Julie A. Kmiec, DO, FASAM ; George Kolodner, MD, DLFAPA, FASAM; Gerald E. Marti, MD, PhD; Lorraine A. Milio, MD, FASAM; William F. Murphy, DO, MS, DFASAM; Carlos F. Tirado, MD, FASAM; Corey Waller, MD, MS, DFASAM, FACEP; Lewis S. Nelson, MD, FASAM. ASAM Guideline on Alcohol Withdrawal Management. Available at: https://www.asam. org/docs/default-source/quality-science/awg-3-20-20.pdf 106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at Copyright © 2020 All rights reserved. ASAMALC04203

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