Background: Alcohol withdrawal is a common issue in hospitalized patients and is associated with significant morbidity and mortality. Alcohol withdrawal occurs when the gamma aminobutyric acid (GABA) stimulating effect of alcohol is removed, resulting in an excess of the excitatory neurotransmitter glutamate. Treatment typically consists of as needed benzodiazepines, which activate GABA. However, this reactive [...]

Background: Although alcohol withdrawal (AW) is common in hospitalized patients, few studies describe contemporary alcohol withdrawal management in hospitalized settings or compare practices to recent guidelines published by the American Society of Addiction Medicine (ASAM). We sought to describe patient characteristics and determine factors associated with complicated withdrawal and treatment duration in hospitalized patients with [...]

Background: Phenobarbital (PB) has important pharmacological advantages over benzodiazepines (BZDs) for treatment of alcohol withdrawal syndrome (AWS). The American Society of Addiction Medicine recommends PB monotherapy as an alternative to BZDs for prophylaxis or treatment of AWS by providers experienced with its use. Few studies have described the use of PB for AWS outside of [...]

Background: Approximately 5% of patients hospitalized at our institution develop clinically significant alcohol withdrawal syndrome (AWS). Inpatients who develop AWS may experience seizures, delirium, ICU transfer and prolonged length of stay. While the mortality of AWS, mostly related to delirium tremens, has decreased over time, severe alcohol withdrawal is still associated with a mortality of [...]