Treatment of the Acute Alcohol-Withdrawal Syndrome

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Abstract
Three primary problems are present during alcohol withdrawal: the need for adequate sedation, correction of dehydration, and correction of acute exogenous and endogenous starvation. Hemoconcentration is present during withdrawal. Experimental studies have demonstrated a defect in adenosine triphosphate synthesis, impeding endogenous metabolism, correctable by glucose administration. Immediate alleviation of dehydration and starvation may be initiated by rapid intravenous infusion of 2000 cc of glucose, 1000 cc of 5% in saline, and 1000 cc of 10% in water. Sedation is best accomplished with chlorpromazine or promazine, 100 mg orally. Vitamins of the B-complex are given parenterally with the glucose solution. Barbiturates are used minimally. Paraldehyde and alcohol are contraindicated. Most patients are ambulatory and will accept food and fluids within 6 hours; prolonged sedation is unecessary; and complications are minimized. In 90% of 500 cases physical and mental symptoms were rapidly controlled. This therapeutic regimen is safe and suited for use in a general hospital.

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