Alcohol withdrawal Quiz: Ace Your Exams

A 21-year-old woman presents to the emergency department for moderate anxiety. She last consumed alcohol approximately 36 hours ago and has been binge drinking regularly at her university about four days a week for the past 10 months. She reports drinking 6–7 mixed drinks each time she drinks. She has never attempted to quit drinking, and she has had no prior withdrawal symptoms. She is not experiencing headaches, nausea, vomiting, hallucinations, or visual or tactile disturbances. The patient has no significant past medical history. She vapes tobacco products and uses marijuana occasionally. Temperature is 37°C (98.6°F), blood pressure is 148/80 mmHg, pulse is 98/min, respiratory rate is 16/min, oxygen saturation is 99% on room air. She has moderately sweaty palms. She has a moderate tremor with hands outstretched. A complete blood count, complete metabolic profile, alcohol level, and magnesium and phosphate levels are within normal limits. The patient is given IV fluids, thiamine, and glucose. Which of the following is the best next step in management?