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Two recommendations from the recent GRACE 4 publication in Academic Emergency Medicine to consider:
1. Use phenobarbital along with benzodiazepines in patients with moderate to severe alcohol withdrawal. The evidence isn’t robust but is positive when compared to benzos alone.
2. Adults with alcohol use disorder can benefit from anti-craving medications such as naloxone and gabapentin at time of discharge.
References
Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department Bjug Borgundvaag PhD, MD, CCFP(EM), Fernanda Bellolio MD, MSc, Isabelle Miles MD, Evan S. Schwarz MD, Sameer Sharif MD, MSc, Mark K. Su MD, MPH, Kevin Baumgartner MD, David B. Liss MD, Hasan Sheikh MD, MPA, Jody Vogel MD, MSc, MSW, Emily B. Austin MD, Suneel Upadhye MD, MSc, Michelle Klaiman MD, FRCPC, DABAM, Robert Vellend, Anna Munkley, Christopher R. Carpenter MD, MSc
First published: 15 May 2024
Academic Emergency Medicine https://doi.org/10.1111/acem.14911