EMU 365 Series: Michelle Klaiman on anti-craving medications for alcohol use disorder

From our 2022 NYGH EM Update conference, ED Physician and addictions specialist Dr. Michelle Klaiman discusses the often “missed opportunity” to initiate anti-craving medications in the Emergency Department for patients who present with signs and symptoms consistent with alcohol use disorder. She emphasizes data pointing to an increase in alcohol related presentations to the ED, as well as deaths related to alcohol since the start of the COVID-19 pandemic. Despite the high morbidity and mortality associated with alcohol use disorder, less than 9% of patients receive an anti-craving medication. These anti-craving medications are safe and effective and can help reduce drinking, ED visits, admissions and overall healthcare costs. Dr. Klaiman succinctly walks through the neurophysiological basis of addiction and how anti-craving medications can help to break the craving-cycle. She discusses how to start Naltrexone and Acamprosate in the emergency department, what the contraindications are to these first-line medications and highlights other anti-craving medications and their specific uses.