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B. Supportive Care
Î Recommendation IV.6: Supportive care is a critical component of
alcohol withdrawal management. Providers should ensure patients are
educated about what to expect over the course of withdrawal, including
common signs and symptoms and how they will be treated.
Î Recommendation IV.7: When treating patients in ambulatory settings,
providers should ensure patients/caregivers are educated about
monitoring for the development of more severe withdrawal and
instructed to create a low-stimulation, reassuring environment at
home to promote an effective outcome.
Î Recommendation IV.8: Patients should be advised to drink non-
caffeinated fluids and that a daily multivitamin may be beneficial.
Î Recommendation IV.9: Patients can be offered oral thiamine. Typical
dosing is 100 mg PO per day for 3–5 days.
Î Recommendation IV.10: Clinicians must explain the importance
of taking medications as prescribed and confirm the patient's
understanding.
Î Recommendation IV.11: Communicate that safe alcohol withdrawal
management may necessitate a transfer to a more intensive level
of care including to an inpatient setting and secure the patient's
agreement to transfer if there are indications that management in the
ambulatory setting is not safe or effective. See Recommendation IV.5
for indications for transfer to a more intensive level of care.
C. AUD Treatment Initiation and Engagement
Î Recommendation IV.12: When feasible, alcohol use disorder (AUD)
treatment should be initiated concurrently with alcohol withdrawal
management as cognitive status permits. If appropriate, clinicians
should offer to initiate pharmacotherapy for AUD as cognitive status
permits. If not initiating AUD treatment themselves, clinicians should
explain the range of evidence-based treatment services available in
the community and engage patients with these options. In addition,
clinicians may offer information about local recovery support groups,
including 12-step groups.
