A group of Canadian and American experts is urging emergency room doctors to prescribe specific medications to help curb cravings and alleviate withdrawal from heavy use of alcohol, which leads to more hospitalizations than any other substance. Guidelines on prescribing by the Society for Academic Emergency Medicine include input from ER physicians, specialists in addiction and patients who experienced harms due to dependence on alcohol. Dr.
Bjug Borgundvaag, lead author of the guidelines published recently in the journal Academic Emergency Medicine, said people who suddenly stop drinking after consuming high amounts of booze can end up with severe withdrawal symptoms, especially seizures and delirium tremens, which include confusion among other symptoms. "Withdrawal can be very dangerous, and in fact it can be fatal. We see it's very common in the emergency department," said Borgundvaag, director of the Schwartz/Reisman Emergency Medicine Institute at the Sinai Health System in Toronto.
The usual medication for moderate to severe alcohol withdrawal syndrome is diazepam, which is sold under the brand name Valium. Instead, the experts recommended phenobarbital along with benzodiazepines, compared to benzodiazepines alone. Some doctors are not familiar with phenobarbital because it's an older drug, but it should be prescribed to patients who will likely be hospitalized, sometimes in an intensive care unit, for symptoms associated with withdrawal, Borgundvaag said.
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