Table 3.
Level of Care for Alcohol Detoxification After Emergent Treatment
| ASAM Criteria Level of Withdrawal Management | Severity of Withdrawal | Patient Needs | Disposition from Emergency Department |
|---|---|---|---|
| Ambulatory withdrawal management | Mild | -Requires less-than-daily outpatient supervision. -Able to follow return precautions. -Likely to adhere to withdrawal management. -Likely to continue AUD treatment. |
Home |
| Ambulatory withdrawal management with on-site monitoring | Moderate | -Withdrawal management support and supervision needed during the day. -Has supportive living environment. -Likely to adhere to withdrawal management. |
Home with family/outpatient support |
| Residential withdrawal management | Moderate | -24 hr support needed to adhere to withdrawal management. -Support important to increase likelihood of continuing treatment for AUD. |
Residential detoxification program with clinical monitoring |
| Medically monitored inpatient withdrawal management | Severe | -24 hr nursing care with physician support as needed. -Unlikely to adhere to withdrawal management without medical monitoring. |
-Residential detoxification program with 24 hr clinical monitoring and nursing care. -Consider inpatient medical floor admission. |
| Medically managed inpatient withdrawal management | Severe, unstable | -Requires 24 hr nursing care with daily physician visits to manage and modify withdrawal. | Inpatient medical floor |
| -History of severe withdrawals, co-morbid medical condition requiring management, pregnancy. | Inpatient medical floor | ||
| -Suicidal or homicidal ideation, co-morbid psychiatric condition requiring active management | Inpatient psychiatric unit | ||
| -Older patients, active delirium tremens, severe agitation requiring sedation for safety. | Intensive care unit |