LAUSR

A is one of the most frequently abused drugs in American society. In 2014, there were 17 million people aged 12 years or older (6.4% of the population) who had an alcohol use disorder (AUD).1 According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), risky alcohol use can place people at increased risk of health consequences.2 Risky alcohol consumption is defined as alcohol intake of 14 drinks per week or more than 4 drinks per day for men younger than 65 years and 7 drinks per week or greater than 3 drinks per day for women younger than 65 years.2 Risky alcohol use usually is not severe enough to constitute AUD, but people who have risky alcohol use may develop AUD. Alcohol use disorder may be classified as mild, moderate, or severe depending on the number of diagnostic criteria present (mild, 2-3 symptoms; moderate, 4-5 symptoms; severe, 6 or more symptoms) (see Table).3,4 The NIAAA defines binge drinking as drinking enough alcohol within 2 hours to raise the blood alcohol concentration to 0.08 g/dL or greater. The amount of alcohol to reach binge drinking level correlates to approximately 5 drinks in men and 4 drinks in women. Alcohol withdrawal syndrome (AWS) symptoms occur when a person stops using alcohol after a period of heavy drinking or chronic use. Patients who have moderate to severe AUD may develop AWS, and up to 30% of patients who have AWS may be admitted to intensive care units (ICUs).5 Patients who are at risk of developing AWS and being admitted to ICUs are susceptible to longer ICU stays, longer time using mechanical ventilation, increased medical costs, and increased mortality rates compared with other patients. Although AWS is not uncommon in critically ill patients, guidelines and standards of care for critically ill patients with AWS are unclear. In this article, we review AWS and discuss the available treatments for critically ill patients with AWS.