Intravenous Acetate as an Adjunctive Treatment for Alcohol Withdrawal in Hospitalized Patients

Alcohol withdrawal syndrome is a highly morbid condition affecting a substantial percentage of patients hospitalized who have alcohol use disorders, estimated at 5-6% of all hospitalized patients. Standard treatment paradigms for alcohol withdrawal syndrome have common and serious side effects, and do not fully address this condition's underlying pathophysiology. This study will examine the feasibility and safety of administering intravenous acetate, an alcohol metabolite and alternative brain fuel, as an adjunctive treatment for alcohol withdrawal in hospitalized patients that will to set the stage for future investigations of its efficacy as an adjunctive treatment in the hospital setting.

Inclusion Criteria: * Active treatment for alcohol withdrawal (e.g. use of protocolized order set in an inpatient setting) * Inpatient admission ordered * Adult \> 21 years old Exclusion Criteria: * End-stage renal disease or likely need for renal replacement therapy in the next 12 hours * Heart failure with reduced ejection fraction (\2L crystalloids prior to randomization * Advanced liver disease (Child's C or D) * Uncontrolled mental health condition * \>24 hours since ED arrival * Pregnant or incarcerated * Unable to consent and/or no proxy