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Evidence-based practice guidelines clearly state that patients at risk for alcohol withdrawal should be monitored and treated with benzodiazepines if their risk is high enough or symptoms are substantial. In a retrospective record review, researchers evaluated whether a protocol for such an approach — symptom-triggered therapy — was followed appropriately at two large general hospitals that offer more than 40 specialty services. The protocol — the Revised Clinical Institute for Withdrawal Assessment for Alcohol (CIWA-Ar) — employs a symptom assessment that required patients to be able to communicate.
Of 124 inpatients who received symptom-triggered therapy, more than half (52%) were treated inappropriately: 35 had no recent heavy alcohol use…