Quality & Science

ASAM Commences Clinical Practice Guideline on Alcohol Withdrawal Management

by ASAM Staff | November 1, 2017

On July 19, 2017, ASAM’s Board of Directors approved alcohol withdrawal management as the topic for its next clinical practice guideline. The Institute for Research, Education and Training in the Addictions (IRETA), will work with ASAM experts under the direction of ASAM’s Quality Improvement Council to develop this guideline over the next year and half.   

“There is a current lack of guidance around alcohol withdrawal management that has led to inadequate clinical practices, particularly in inpatient medical and surgical units, and patients are suffering as a result,” said Dr. Kelly Clark, MD, MBA, DFASAM, President of ASAM.

ASAM’s guideline will address these issues and identify the best practices for managing alcohol withdrawal in both inpatient and outpatient settings. It will also complement the guideline underway by the American Psychiatric Association (APA) on the pharmacological treatment of patients with alcohol use disorder.

The guideline will use a hybrid methodology combining the Veterans Health Administration and Department of Defense (VA/DoD), Grading of Recommendations, Assessment, Development and Evaluations (GRADE), RAND/UCLA Appropriateness Method (RAM) methodologies. As a first step, ASAM-appointed clinical champions will work to assist IRETA with the critical upfront work of project scope definition and guideline statement development, as well as external review and dissemination process.

The GRADE methodology will then be utilized during the literature review process to assess the quality of the research and existing guidelines. This methodology will ensure that we will filter out anything that is not heavily supported by the literature and are left with what is considered the gold standard.

Finally, the RAND/UCLA methodology will be utilized when developing clinical recommendations, which combines scientific evidence as well as the judgement of our expert panel to further refine the set of guidelines. By allowing the expert panel to raise subjects that are not thoroughly vetted in the literature, this methodology will ensure that the clinical recommendations are both accurate and practical. An external comment period is expected to take place by the end of 2018.

“By utilizing this progressive approach, ASAM will be able to provide much-needed guidance to improve the quality of care that patients with alcohol use disorder receive,” said Dr. Margaret Jarvis, MD, DFASAM, Chair of ASAM’s Quality Improvement Council.

The alcohol withdrawal management guideline is anticipated to be finalized by the first quarter of 2019. For more information, please contact ASAMguideline@ASAM.org