Trends in the Management of Inpatients With Alcohol Withdrawal Syndrome

It is estimated that about 8% of patients with alcohol use disorder develop withdrawal symptoms when admitted to the hospital. There are a variety of medications typically used for alcohol withdrawal syndrome (AWS) and the purpose of this study was to assess patterns of medication use for inpatients with an AWS. We searched the Explorys IBM Watson Health Database for patients coded with AWS and an inpatient encounter from the years 2016 to 2019. We then searched for medication use associated with the admission focusing on benzodiazepines, barbiturates, antiepileptics, haloperidol, clonidine, and baclofen. During the 4-year study analysis, we identified 96,050 inpatients. Benzodiazepines were used in a number greater than the number of inpatients suggesting the use of multiple agents. The antiepileptics were used sparingly varying from 2% to 14% by an agent. Clonidine was used in 42% of patients and haloperidol in 44% of patients. Phenobarbital was rarely used. Baclofen was used in the same frequency as some of the antiepileptics. In summary, adjunctive agents with literature support such as carbamazepine were used sparingly. Many patients receive clonidine and haloperidol. Opportunities seem to exist to expand the use of adjunctive agents.