Drinking History
Treatment
Withdrawal
Stabalization
Case Management
Service Delivery

Medical Withdrawal From Alcohol 

It should be assumed that pregnant women who consume over 8 ounces of [absolute] alcohol (1 pint of liquor) daily have developed tolerance. However, tolerance may develop at lower levels of consumption in some women and in women using multiple drugs.

The sudden cessation of drinking can result in withdrawal symptoms, some of which may be threatening to the mother and the fetus. It is imperative that medical withdrawal of an alcohol-dependent, pregnant woman be conducted in an inpatient setting and under medical supervision that includes collaboration with an obstetrician. These conditions will ensure

• Close observation and monitoring of maternal alcohol withdrawal status
• Continual monitoring of foetal well-being

Most programs choose to treat the pregnant, alcohol-dependent woman with short-acting barbiturates or benzodiazepines. Chlordiazepoxide (Librium) and other benzodiazepines, such as diazepam (Valium) and barbiturates (Phenobarbital, Seconal), are valuable for symptomatic treatment during medical withdrawal from alcohol. They are also potentially teratogenic. Some clinicians, therefore, recommend avoiding their use if at all possible. The risks versus the possible benefits of their use need to be assessed.

Disulfiram (Antabuse) is contraindicated during pregnancy. Its use has been associated with clubfoot, VACTERL syndrome (a pattern of congenital anomalies), and phocomelia of the lower extremities.  The woman who conceives while taking this drug should receive counselling before deciding to continue the pregnancy.