The UK’s National Institute for Health and Clinical Excellence (NICE) has produced guidelines on alcohol-related physical complications, including alcohol withdrawal syndrome, Wernicke’s encephalopathy, acute and chronic pancreatitis, and acute alcoholic hepatitis.
The acute alcohol withdrawal section includes the following recommendations:
Offer drug treatment for the symptoms of acute alcohol withdrawal, as follows:

• Consider offering a benzodiazepine or carbamazepine.
• Clomethiazole may be offered as an alternative to a benzodiazepine or carbamazepine. However, it should be used with caution, in inpatient settings only and according to the summary of product characteristics.
• Follow a symptom-triggered regimen for the drug treatment of acute alcohol withdrawal in people who are:
  • in hospital or
  • in other settings where 24-hour assessment and monitoring are available.

Treatment for delirium tremens or seizures

• Offer oral lorazepam as first-line treatment for delirium tremens. If symptoms persist or oral medication is declined, give parenteral lorazepam, haloperidol or olanzapine.
• For people with alcohol withdrawal seizures, consider offering a quick-acting benzodiazepine (such as lorazepam) to reduce the likelihood of further seizures.
• If delirium tremens or seizures develop in a person during treatment for alcohol withdrawal, review their withdrawal drug treatment.
• Do not offer phenytoin to treat alcohol withdrawal seizures.

Alcohol-use disorders: Diagnosis and clinical management of alcohol-related physical complications
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