**8. Conclusions**

In summary, alcohol withdrawal is a complex condition with a wide range of manifestations which results in substantial morbidity and mortality. The underlying pathophysiology of ethanol – chronic GABAergic stimulation – results in a hyperexcitatory state when alcohol withdrawal occurs. Symptoms range from anxiety and tremulousness to seizures, coma, and death. Practitioners should be able to identify patients with AWS risk stratify patients who are at risk of complicated AWS utilizing the various described screening tools. Symptom based assessment tools are also available to guide treatment (CIWA or SEWS). Primary treatment for AWS requires sufficient dosing of GABA agonists (benzodiazepines vs. phenobarbital). Adjunctive therapies also include ketamine and dexmedetomidine, the latter of which should be used cautiously as it does not address the underlying pathophysiology. To ensure patient safety, clinicians should strive to monitor for and prevent known risks and complications associated with AWS. Finally, a multi-disciplinary approach is preferred and should include the expertise of addiction specialists from Addiction Medicine, Addiction Psychiatry, or Medical Toxicology, as well as Case Management.
