A patient with a substance use disorder is being monitored for withdrawal symptoms. Which medication might be used to manage alcohol withdrawal?

Choice A rationale Disulfiram is a medication used as a deterrent for alcohol use disorder. It works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to an aversive reaction when alcohol is consumed. It is not used to manage the acute withdrawal symptoms but rather to prevent future alcohol consumption. Choice B rationale Naltrexone is an opioid receptor antagonist used to reduce alcohol cravings in individuals with alcohol use disorder. It does not treat the acute symptoms of alcohol withdrawal but helps to maintain abstinence by reducing the rewarding effects of alcohol, thereby reducing the desire to drink. Choice C rationale Methadone is a long-acting opioid agonist used for the treatment of opioid use disorder. It is used to manage withdrawal symptoms from opioids but has no role in the management of alcohol withdrawal syndrome, which is a separate and distinct medical condition. Choice D rationale Benzodiazepines, such as lorazepam or diazepam, are the first-line treatment for alcohol withdrawal syndrome. They work by enhancing the effects of gamma-aminobutyric acid (GABA), the brain's main inhibitory neurotransmitter, which counteracts the central nervous system hyper-excitability characteristic of alcohol withdrawal.