From the FDA Drug Label
Diazepam is indicated for the management of anxiety disorders or for the short- term relief of the symptoms of anxiety. In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis
The primary approach for treating alcohol intoxication without poisoning is not directly addressed in the provided drug label.
- The label discusses the use of diazepam in acute alcohol withdrawal, but not specifically for alcohol intoxication.
- Diazepam may be useful in relieving symptoms associated with alcohol withdrawal, such as agitation and tremor 1. However, the label does not provide information on the treatment of alcohol intoxication without poisoning.
From the Research
The primary approach for treating alcohol intoxication without poisoning is supportive care, allowing the body to metabolize the alcohol naturally, and administering thiamine to prevent Wernicke's encephalopathy in high-risk individuals, as supported by the most recent and highest quality study 2.
Key Components of Treatment
- Ensuring the person is in a safe environment to prevent injury
- Maintaining proper hydration with oral or intravenous fluids if needed
- Monitoring vital signs until the intoxication resolves
- Positioning the patient to prevent aspiration if vomiting occurs
- Close observation for worsening symptoms or complications
Thiamine Administration
- Thiamine (100 mg IV or IM) may be administered to prevent Wernicke's encephalopathy, particularly in those with chronic alcohol use or malnutrition, as recommended by 3 and 4
- The route and dosage of thiamine may vary, but clinical judgment should be exercised in diagnosis and treatment, with consideration of the patient's individual needs and risk factors
Additional Considerations
- Glucose may be given if hypoglycemia is present
- The body metabolizes alcohol at a relatively constant rate, so recovery is primarily a matter of time
- Attempting to "sober up" with caffeine, cold showers, or other home remedies does not accelerate alcohol metabolism and may give a false sense of sobriety while potentially masking symptoms, as noted in 2
Patient Population
- Adolescents are more exposed to the toxic effects of alcohol and may require closer monitoring and more aggressive treatment, as highlighted in 2
- Patients with chronic alcohol use or malnutrition are at higher risk for Wernicke's encephalopathy and should receive prophylactic thiamine therapy, as recommended by 5 and 4