Routine hospital alcohol detoxification practice compared to symptom triggered management with an Objective Withdrawal Scale (CIWA-Ar)

Am J Addict. Spring 2000;9(2):135-44. doi: 10.1080/10550490050173208.


Charts of patients hospitalized for uncomplicated alcohol withdrawal were examined and detoxification practices compared. Patients detoxified using a Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) based PRN protocol on the addiction unit received significantly fewer chlordiazepoxide milligram equivalents over shorter duration than patients managed by other detoxification methods on other hospital units. Significantly fewer patients received benzodiazepines in the CIWA-Ar protocol managed group, but inter-group differences (p < 0.01) remained when only medicated patients were compared. Differences between the protocol and non-protocol groups did not reach statistical significance when PRN only strategies were examined, suggesting that the use of a symptom-triggered strategy may account for the noted effects.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Alcohol Withdrawal Delirium / diagnosis*
  • Alcoholism / rehabilitation*
  • Chlordiazepoxide / administration & dosage
  • Female
  • Hospitalization*
  • Hospitals, Veterans
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neurologic Examination* / drug effects
  • Outcome and Process Assessment, Health Care
  • Oxazepam / administration & dosage
  • Washington


  • Oxazepam
  • Chlordiazepoxide