The Society for Academic Emergency Medicine (SAEM) has released the fourth Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4), which focus on managing nonopioid use disorders such as alcohol withdrawal syndrome (AWS), alcohol use disorder (AUD), and cannabinoid hyperemesis syndrome (CHS). The guidelines recommend phenobarbital for severe alcohol withdrawal, naltrexone/acamprosate for AUD, and gabapentin with caution. For CHS, haloperidol, droperidol, or topical capsaicin are suggested. The study was led by Bjug Borgundvaag and published online in Academic Emergency Medicine. Limitations include topic selection and lack of direct evidence, with funding from SAEM. Disclosures show potential conflicts among SAEM GRACE-4 Writing Team members.
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Updated Guidelines for Nonopioid Use Disorders in the ED
