INTRODUCTION

Minor manifestations of alcohol withdrawal include anxiety, agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving, and often loss of appetite, nausea, and vomiting. Moderate and severe withdrawal syndromes can include hallucinations, seizures, or delirium tremens; the latter two can be life-threatening.

Most people with alcohol use disorder do not experience significant withdrawal when they stop or reduce drinking, but withdrawal is common among medical and surgical inpatients and in emergency departments.

This topic reviews the clinical manifestations, course, assessment and diagnosis of alcohol withdrawal. Ambulatory and inpatient management of alcohol withdrawal syndromes are reviewed separately. (See "Alcohol withdrawal: Ambulatory management" and "Management of moderate and severe alcohol withdrawal syndromes".)

The epidemiology, pathogenesis, clinical manifestations, course, screening, assessment, diagnosis, and treatment of risky drinking and alcohol use disorder are also reviewed separately. (See "Risky drinking and alcohol use disorder: Epidemiology, clinical features, adverse consequences, screening, and assessment" and "Alcohol use disorder: Psychosocial management" and "Alcohol use disorder: Pharmacologic management".)

EPIDEMIOLOGY

In a community-based sample of adults in the United States, the past-year prevalence of alcohol use disorder was 11.2 percent [1] and has been found to be 11 to 32 percent among inpatients in medical units [2,3]. Approximately half of patients with alcohol use disorder experience alcohol withdrawal when they reduce or stop drinking [4,5].