New Guideline Addresses Significant Care Gap in Alcohol Withdrawal Treatment in Correctional Settings

Posted Jan 10, 2014

Chicago (January 10, 2014) – Alcohol withdrawal syndrome (AWS), prevalent among individuals entering holding cells and jails, can progress to delirium tremens and death. National surveys show significant gaps in quality for management of AWS in corrections, including underuse of recommended protocols for detoxification. Since AWS represents an important preventable cause of death in corrections, the National Commission on Correctional Health Care has issued a new guideline for alcohol detoxification in correctional settings.

The general approach to AWS comprises four essential components:

  • Universal screening. All inmates should be screened for potential AWS symptoms upon entry into the facility from the community.
  • Medical evaluation. All inmates who screen positive should be referred for medical clearance and formally assessed for AWS using a standardized instrument. A trained clinician should use a validated withdrawal assessment instrument such as the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised(CIWA-Ar).
  • Detoxification. All inmates with clinically significant AWS should be treated with effective medication.
  • Referral for substance abuse treatment. All inmates with AWS should be educated about their disease and referred for substance abuse evaluation and treatment following detoxification.

Detoxification does not treat the underlying disease of addiction. All patients with an alcohol disorder and/or AWS should be educated about their condition and the risks associated with AWS and offered alcohol treatment. Depending on circumstances, the patient should be offered enrollment in treatment programs within the facility or referred upon release to comprehensive treatment programs that offer both behavioral and pharmacological treatment. Engagement in community treatment should be done quickly because correctional release often triggers relapse.

The guideline is available for free download at

About NCCHC: The National Commission on Correctional Health Care is a not-for-profit 501(c)(3) organization working to improve the quality of care in our nation’s jails, prisons and juvenile detention and confinement facilities. Programs and resources include standards for health services, mental health services and opioid treatment programs in correctional facilities, voluntary accreditation programs for facilities that meet these standards, educational trainings and conferences, publications, and professional certification. NCCHC is supported by the major national organizations representing the fields of health, law and corrections. Each of these organizations has named a liaison to the NCCHC board of directors. Learn more at

NCCHC Supporting Organizations: Academy of Correctional Health Professionals, Academy of Nutrition and Dietetics, American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Academy of Physician Assistants, American Academy of Psychiatry and the Law, American Association of Public Health Physicians, American Bar Association, American College of Emergency Physicians, American College of Healthcare Executives, American College of Obstetrics and Gynecology, American College of Neuropsychiatrists, American College of Physicians, American College of Preventive Medicine, American Correctional Health Services Association, American Counseling Association, American Dental Association, American Health Information Management Association, American Jail Association, American Medical Association, American Nurses Association, American Osteopathic Association, American Pharmacists Association, American Psychiatric Association, American Psychological Association, American Public Health Association, American Society of Addiction Medicine, Association of State and Territorial Health Officials, International Association for Correctional and Forensic Psychology, National Association of Counties, National Association of County and City Health Officials, National Association of Social Workers, National Medical Association, National Partnership for Juvenile Services, National Sheriffs' Association, Society for Adolescent Health and Medicine and Society of Correctional Physicians.