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
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