Alcohol use disorder (AUD) is a common and costly disease. Alcohol withdrawal is a common complication of AUD. Alcohol withdrawal has primarily been managed in the inpatient setting, though evidence supports treatment in the outpatient setting for selected low-risk patients. Benzodiazepines are the gold standard medication class to prevent complications of alcohol withdrawal and may be given in symptom-triggered, fixed-schedule, and loading dose regimens. Medications for the treatment of AUD are effective and underutilized. There are three medications approved by the US Food and Drug Administration for AUD: naltrexone (available in short-acting oral and long-acting injectable formulations), acamprosate, and disulfiram. Naltrexone and acamprosate are preferred in most settings due to their efficacy and tolerability. Patients with moderate to severe AUD should be offered medication as part of their treatment plan along with a comprehensive history and physical, behavioral treatment, and mutual goal-setting. It is recommended that medications for AUD are continued for at least 6–12 months or until their risks outweigh their benefits. This chapter reviews the medication management of alcohol withdrawal and AUD in detail.
1246: PHENOBARBITAL VERSUS BENZODIAZEPINES FOR ALCOHOL WITHDRAWAL IN THE INPATIENT SETTING
