GuidelinesPEML (Paeds Hospital STG)
Alcohol Withdrawal
Alcohol Withdrawal
General and supportive measures
ICD-10 code: F10.239
GENERAL AND SUPPORTIVE MEASURES
Refer children under 6 years and patients with:
- convulsions,
- psychiatric illnesses: psychosis, intellectual impairment,
- suicidal ideation,
- significant medical co-morbidity such as heart disease; pregnancy,
- inadequate social support, and
- a history of withdrawal delirium.
Assess for co-morbid infections and other pathology.
Ensure adequate hydration. Over-hydration is a common error made in this setting.
MEDICATION TREATMENT
Alcohol detoxification may be managed on an outpatient basis in cases of mild, uncomplicated alcohol withdrawal.
- Thiamine: oral.
- Children: 0.5 - 1 mg/kg daily for 14 days.
- Adults: 50 mg daily for 14 days.
- Diazepam: oral.
- 1 - 6 years: 1 - 6 mg/day.
- 6 - 14 years: 2 - 10 mg daily in 2 - 3 divided doses.
- > 14 years: up to 20 mg daily in 2 - 3 divided doses.
- Wean dose from 8 hourly, to 12 hourly, to daily every 3 - 5 days.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 14: Child & Adolescent Psychiatry, 14.13 Substance Use Disorder, 14.13.3 Substance Withdrawal, 14.13.3.1 Alcohol Withdrawal