Start aggressive Benodiazepine therapy at CIWA score of 8. Consider ICU admission with score >20
Diazepam (Valium) 5-10 mg IV (depending on severity)
May repeat q5-10 min for severe withdrawal (may increase dose by 10 mg every 5-10 min until desired effect achieved, max dose of 200 mg)
Half-life 20-100 h (long acting)
Lorazepam (Ativan) 1-4mg IV (depending on severity)
May repeat q15-20 min for severe withdrawal (titrated to effect)
Rarely causes hepatitis, as opposed to diazepam which may cause a cholestatic hepatitis
Half-life 10-20 h (medium acting)
May repeat q5-10 min for severe withdrawal (may increase dose by 10 mg every 5-10 min until desired effect achieved, max dose of 200 mg)
Half-life 20-100 h (long acting)
May repeat q15-20 min for severe withdrawal (titrated to effect)
Rarely causes hepatitis, as opposed to diazepam which may cause a cholestatic hepatitis
Half-life 10-20 h (medium acting)
For use in cases refractory to benzodiazepine treatment
Propofol
If patient does not respond to high doses of benzodiazepines
0.3-1.25 mg/kg up to 4 mg/kg/hr (consider intubation), for up to 48 hours
Barbiturates (Phenobarbital)
Used when refractory to benzodiazepines (consider after patient has received equivalent of 200 mg diazepam)
Phenobarbital 130-260 mg IV q 15-20 minutes
Can also be used as a first line load at 10 mg/kg prior to giving benzodiazepines to decrease benzodiazepine requirements and ICU admissions 
α-2 agonists (Dexmedetomidine)
Decrease severity of symptoms, but only supplemental to GABA-ergic first-lines
Dexmedetomidine drip, start 0.2 mcg/kg/min, likely needing no more than 0.7 mcg/kg/min
Ketamine
May have some use in refractory cases
Blocks the NMDA receptor which is excited an unregulated. 
If patient does not respond to high doses of benzodiazepines
0.3-1.25 mg/kg up to 4 mg/kg/hr (consider intubation), for up to 48 hours
Used when refractory to benzodiazepines (consider after patient has received equivalent of 200 mg diazepam)
Phenobarbital 130-260 mg IV q 15-20 minutes
Can also be used as a first line load at 10 mg/kg prior to giving benzodiazepines to decrease benzodiazepine requirements and ICU admissions 
Phenobarbital 130-260 mg IV q 15-20 minutes
Can also be used as a first line load at 10 mg/kg prior to giving benzodiazepines to decrease benzodiazepine requirements and ICU admissions 
Decrease severity of symptoms, but only supplemental to GABA-ergic first-lines
Dexmedetomidine drip, start 0.2 mcg/kg/min, likely needing no more than 0.7 mcg/kg/min
May have some use in refractory cases
Blocks the NMDA receptor which is excited an unregulated. 
The propylene glycol diluent in lorazepam, phenobarbital, and diazepam, may induce a hyperosmolar anion gap metabolic acidosis if given as a drip in high doses ≥ 48hrs.  Consider alternatives such as propofol or dexmedetomidine if patients need long term sedation for delirium tremens.
At risk for thiamine deficiency, but no symptoms: thiamine 100mg PO q day
Give multivitamin PO; patient at risk for other vitamin deficiencies
The majority of chronic alcoholics do NOT require a banana bag
Thiamine 100mg IV
Folate 1mg IV (cheaper PO)
Multivitamin 1 tab IV (cheaper PO)
Magnesium sulfate 2mg IV
Normal saline as needed for hydration
Alcohol withdrawal
Ethanol toxicity
Benzodiazepine withdrawal
Alcohol use disorder
Opioid withdrawal
Cocaine withdrawal
Alcohol withdrawal seizures
Barbiturate withdrawal