CIWA-AR scores : 8 points or less = mild withdrawal 9 –15 points = moderate withdrawal Greater than 15 = Severe withdrawal with increased risk of seizures and D.T.’s Note: A patient may present initially with mild symptoms of withdrawal because their blood alcohol level is still high. Hence the value of daily assessment.
The Importance of Outpatient Detoxification.
Patients successfully treated for AWS should be referred to a long-term treatment program to maintain abstinence.
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort .
As with many outpatient services, outpatient alcohol detox allows patients to return home or to their chosen sober living facility at the end of each day. This can be more cost-efficient if you are already in a good place mentally, are dedicated to wellness and recovery, and have a strong support system at home. If alcohol use disorder is not severe, outpatient detox may take the place of a residential detox program. In many cases, outpatient detox offers a great follow-up to residential detox.
Treatment goals for patients with AWS are to reduce withdrawal symptoms; prevent seizures, delirium tremens, and death; and prepare the patient for long-term abstinence from alcohol use. Adequate and prompt treatment diminishes the severity of future withdrawal episodes and the risk of the patient resuming alcohol use.18 Alcohol withdrawal seizures can occur 24 to 72 hours after the last alcohol intake, are typically tonic-clonic, and last less than five minutes. Up to one-third of patients with AWS who have a related seizure will progress to delirium tremens.19.