By Alex Kats, MD
South Puget Sound Pharmacy and Therapeutics Committee Chair
Imagine this: A patient arrives in the emergency department, shaky, sweating, and anxious — clear signs of alcohol withdrawal. The traditional approach in some hospitals? Supplying alcohol to "taper" withdrawal symptoms. But is that really the best strategy?
At Providence, we’re committed to evidence-based care, which is why we after review at Pharmacy and Therapeutics Committee in July 2024, decided to start following the CIWA protocol instead.
Here’s why it’s the smarter, safer choice:
1. Targeted, Patient-Centered Treatment
The CIWA protocol is a structured, symptom-driven assessment that ensures patients get precisely the care they need—no more, no less. Instead of a one-size-fits-all approach like alcohol tapering, CIWA allows providers to tailor medication (such as benzodiazepines) based on the severity of withdrawal symptoms, improving both safety and effectiveness.
2. Reducing Risks and Complications
While alcohol may seem like a quick fix, it’s unpredictable—leading to inconsistent blood alcohol levels, increased risk of delirium, and potential interactions with other medications. CIWA, on the other hand, ensures controlled symptom management, reducing the likelihood of seizures, cardiac complications, or worsening withdrawal.
3. Supporting Long-Term Recovery
Supplying alcohol in a hospital setting reinforces dependence, whereas CIWA helps guide patients toward stabilization and potential treatment for alcohol use disorder. By prioritizing structured medical care, we help set the stage for long-term recovery rather than temporary symptom suppression.
4. Standardized, Evidence-Based Care
The American Society of Addiction Medicine (ASAM) and major healthcare organizations endorse CIWA as the gold standard for alcohol withdrawal management. It ensures consistency across providers, preventing outdated or subjective treatments.
Better Care Starts with Smarter Protocols
By choosing CIWA over alcohol administration, we’re not just treating withdrawal—we’re improving outcomes, enhancing patient safety, and setting the foundation for sustainable recovery.
Questions about CIWA implementation? Let’s talk. Please contact me regarding this change or inpatient pharmacy regarding ordering questions.
