Alcohol Withdrawal & Recovery Treatment

Individuals with alcohol use disorder are at risk of developing Alcohol Withdrawal Syndrome (AWS). Alcohol Withdrawal Syndrome (AWS) is a medical condition that can occur when someone who has been drinking heavily over time suddenly stops or significantly reduces their alcohol intake. It’s not a sign of weakness or failure—it’s the body’s physiological response to a substance it has come to depend on. For many, alcohol has been a coping tool, a way to manage pain, trauma, or stress. When someone chooses to stop drinking, it’s often a courageous step toward healing, and at Fine Tune Psychiatry we support that journey.

Withdrawal symptoms can be mild (like anxiety, insomnia, or tremors). More severe and potentially life-threatening symptoms include agitation, nausea, sweating, vomiting, hallucinations, insomnia, rapid heartbeat, high blood pressure, seizures and delirium tremens (DTs). These symptoms typically begin within 6 to 24 hours after the last drink and may peak between 24 to 72 hours. Because the brain and body have adapted to alcohol’s depressant effects, removing it can cause the nervous system to become overactive, leading to these symptoms.

The goal of medical management for AWS is to reduce symptoms, prevent serious complications, and support long-term recovery. At Fine Tune Psychiatry we use evidence-based protocols that use medications for treating AWS safely and provide compassionate support.

Outpatient treatment for Alcohol Withdrawal Syndrome (AWS) can be safe and effective for many individuals, but it requires careful screening to ensure medical stability and safety.

Candidates for Outpatient AWS Treatment

• Mild to Moderate Withdrawal Symptoms: Individuals experiencing symptoms like tremors, anxiety, insomnia, nausea, or mild agitation—without signs of severe complications—may be treated safely outside of a hospital setting. Our experts use an evidence-based screening tool to assess withdrawal and determine the safety of outpatient treatment.
• Stable Medical and Psychiatric Status: Patients should not have unstable medical conditions (e.g., heart disease, uncontrolled hypertension, seizure disorder) or severe psychiatric comorbidities (e.g., active suicidality, psychosis). Pregnant patients should seek inpatient treatment but will not be turned away if this is not possible as the effects of alcohol on the baby are more detrimental than the risk of outpatient treatment.
• No History of Severe Withdrawal: Those without a history of seizures, delirium tremens (DTs), or other life-threatening withdrawal symptoms are better candidates for outpatient care.
• Supportive Home Environment: A safe, substance-free living situation with access to supportive individuals (family, friends, or caregivers) is ideal.
• Reliable Transportation and Communication: It is ideal if patients are able to attend daily follow-ups however telehealth follow-ups are available for those with transportation barriers. Patients must be able to reach out for help if symptoms worsen.
• Motivation and Engagement: Motivation to participate in treatment, follow medical guidance, and engage in long-term recovery planning supports success.

Who Should Be Treated Inpatient

• Severe withdrawal symptoms (e.g., hallucinations, seizures, DTs)
• History of complicated withdrawal
• Lack of social support or housing
• Co-occurring medical or psychiatric instability
• Pregnancy if possible

Treatment for AWS

Outpatient care often includes daily monitoring, treatment with a medication called gabapentin (the evidence supports benzodiazepines for treating AWS, but this is used at the provider’s discretion as it can have implications for safety; benzodiazepines will not be used in anyone with a history of misuse of this class of medication). Treatment will include a plan for long-term treatment of alcohol use disorder. Compassionate, trauma-informed care at Fine Tune Psychiatry ensures that individuals are not judged for their alcohol use but are supported in their healing journey.

At Fine Tune Psychiatry, we carefully evaluate candidates for safe outpatient alcohol detox. Before starting, patients will be evaluated by one of our specialists in managing AWS. The provider will assess the patient’s withdrawal, take a full history, order labs, and create a personalized treatment plan. The detox program itself generally lasts five days and serves as the first step toward ongoing recovery, which often includes medicated assisted treatment for alcoholism, therapy, medication management, and support group participation.

Therapy for AWS

• Our clinicians can incorporate therapy into their sessions, including:
• Cognitive Behavioral Therapy (CBT)
• Exposure Therapy
• Supportive Therapy
• Motivational Interviewing
• Accountability for healthy behaviors and routines, such as diet, exercise, avoidance of problematic behaviors and others.

Our AWS & Outpatient Detox Program

• A 60–90 minute psychiatric evaluation with Nicole Leighton CRNP PMHNP, Director of Substance Use Treatment Services or other trained specialists, before starting the protocol.
• Labs may be ordered after the initial evaluation to check electrolytes, liver function and vitamin deficiencies
• A psychiatric evaluation will be administered when appropriate to address co-occurring mental health disorders. This may have to wait until the patient is more stable.
• Patient and provider will have daily check-ins during the withdrawal management protocol.
• Patients will agree to seek urgent or emergency care if instructed by the provider.
• A reliable support person will be involved in the process where possible.
• Most major insurance plans are accepted.

Why Choose Fine Tune Psychiatry for AWS Management?

Treatment is led by our Director of Substance Use Treatment Services, a psychiatric nurse practitioner with expertise in treating AWS and mental health conditions. Our team includes board-certified psychiatrists, nurse practitioners, and doctoral-level therapists experienced in treating AWS. We provide academically oriented care, with many of our providers having taught at institutions such as Johns Hopkins and the University of Pennsylvania.

Highlights of our program include:

• Our Director of Substance Use Treatment, Nicole Leighton CRNP, PMHNP-BC, experienced in the treatment of medically managed AWS
• Board-certified providers with specialized training in addiction treatment
• Appointments available as soon as possible within one week
• Both in-office and virtual treatment options
• Comprehensive support for co-occurring psychiatric disorders
• Compassionate, nonjudgmental approach

Director of Substance Use Treatment Services

Nicole Leighton CRNP PMHNP-BC brings expertise in the treatment of addiction including Opioid Use Disorder and Alcohol Use Disorder with MAT. She also treats other substance use disorders with the most current evidence-based approaches. She is an expert in treating co-occurring mental health and substance use disorders. Nicole works with pregnant and parenting women with opioid use disorder and severe mental health conditions at Thomas Jefferson University’s Maternal Addiction Treatment Education and Research (MATER) and is Clinical Adjunct Faculty at Thomas Jefferson University, mentoring psychiatric nurse practitioner students and providing lectures on substance use, substance use in pregnancy and harm reduction strategies. Book an appointment with Nicole. Find hope today.