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Pharmacologic and Non-Pharmacologic Treatments for Alcohol Withdrawal in the Outpatient Setting: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: November 7, 2014
Project Number: RC0603-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of pharmacologic and non-pharmacologic treatments for alcohol withdrawal in an outpatient setting?
  2. What is the cost-effectiveness of pharmacologic and non-pharmacologic treatments for alcohol withdrawal in an outpatient setting?
  3. What are the evidence-based guidelines regarding the management of alcohol withdrawal in an acute care outpatient setting?

Key Message

Five head to head RCTs and two placebo-controlled RCTs met the inclusion criteria. The RCTs evaluated pharmacological treatments but these differed in terms of agents being compared, dosage forms, dosing regimens, administration schedule, and outcomes measured. This makes it challenging to draw conclusions on the relative efficacy of medications used for the outpatient treatment of alcohol withdrawal. One set of guideline recommends oral long acting benzodiazepines as the treatment of choice. No trials were found on the clinical effectiveness of non-pharmacologic treatments. No economic evaluations were found and hence no conclusions can be made on the cost-effectiveness.