ASAM Pocket Guidelines and Patient Guide

Alcohol Withdrawal Management

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11 Level 2-WM Appropriate Neutral/Uncertain Inappropriate Mild or moderate (e.g., CIWA-Ar <0–18). Severe but not complicated (e.g., CIWA-Ar ≥19). Complicated (e.g., CIWA- Ar ≥19). Physiological dependence on opioids or OUD. Withdrawing from other substance(s). Physiological dependence on BZDs or BZD use disorder. Severe withdrawal >1 year ago. Previous complicated withdrawal episode. Recent severe withdrawal episode. Previous failure to benefit from Amb-WM. Medical or psychiatric condition that needs inpatient treatment. Older age. History of epilepsy. Moderate, active, and potentially destabilizing medical problem. History of non-alcohol related seizure. Clinically significant abnormal lab results. Suspected head injury. Moderate to severe active and potentially destabilizing medical problem including unstable chronic condition. Unable to take oral medications.

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