Anti-craving Medications in the Emergency Department

In this video, we explore the crucial role that emergency clinicians play in managing alcohol use disorder and the effective use of anti-craving medications. Given that alcohol use disorder frequently presents in the emergency department, clinicians are uniquely positioned to initiate treatment that addresses the underlying cravings driving compulsive alcohol consumption. We cover medications such as naltrexone, a mu receptor antagonist that reduces alcohol cravings by disrupting the brain’s reward cycle and making alcohol less pleasurable. We also discuss acamprosate, which is suitable for patients with liver issues, and disulfiram, an aversive therapy for those who have previously responded well to it. Additionally, we highlight the use of topiramate, gabapentin, and baclofen, which are not approved by the FDA to treat AUD but have proven effective when used off-label to treat alcohol use disorder. This video underscores the importance of initiating these treatments in the emergency department to manage alcohol use disorder effectively. SAMHSA does not condone the use of non-FDA-approved medications to treat alcohol use disorder.