A patient who was in a motor vehicle crash is suspected of alcohol withdrawal. Which medication is typically given first?

• A. Benzodiazepine
• B. Acetaminophen
• C. Antibiotic
• D. Antihypertensive

Answer: (A)

When alcohol withdrawal is suspected, the priority is to calm CNS hyperexcitability and prevent seizures. A benzodiazepine does this by enhancing GABA inhibition, which reduces agitation, autonomic instability, and the risk of progression to severe withdrawal or delirium tremens. This makes it the first-line treatment for suspected alcohol withdrawal, with dosing adjusted to the severity of symptoms (often guided by a scale like CIWA-Ar).

Acetaminophen would only treat pain or fever, not the withdrawal process. Antibiotics target infection, which isn’t the immediate issue here. Antihypertensives might help with elevated blood pressure but don’t address the underlying CNS hyperexcitability as effectively as a benzodiazepine.