{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:39:49Z","timestamp":1788928789652,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Internal Grant Agency\u2013Lehigh Valley Health Network Research Support Fund"},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["75D30120C07819"],"award-info":[{"award-number":["75D30120C07819"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000038","name":"U.S. Food and Drug Administration","doi-asserted-by":"publisher","award":["75F40122D00028"],"award-info":[{"award-number":["75F40122D00028"]}],"id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Alcohol withdrawal syndrome (AWS) requires urgent treatment to prevent morbidity and mortality. In the acute care setting, medical toxicologists play a critical role in AWS management, including the use of gamma-aminobutyric acid agonists and adjunctive medications. We aim to introduce the addiction medicine community to this role by describing clinical presentation and treatment of patients with AWS in the Toxicology Investigators Consortium Core Registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medical toxicologists from participating sites enter demographic, exposure, clinical presentation, and treatment data on all patients they evaluate into the Core Registry. This was a secondary analysis of registry patients evaluated for AWS from 2016 to 2022. Data were coded in a spreadsheet and analyzed using descriptive statistics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 1093 cases. Agitation and delirium\/toxic psychosis were documented in 373 (34.1%) and 227 (20.8%) patients, respectively. Benzodiazepines were the most common gamma-aminobutyric acid agonist treatment (n\u2009=\u2009539, 49.3%). There was an overall decrease in the use of benzodiazepines alone and increases in the use of phenobarbital, ketamine, and dexmedetomidine. Intubation was performed in 115 (10.5%) patients. Naltrexone, used for alcohol use disorder, was given in 88 (8.1%) cases. The absolute number of AWS cases increased during this period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Use of benzodiazepines alone to manage AWS decreased while phenobarbital, ketamine, and dexmedetomidine use increased. Many patients had severe withdrawal manifestations, and some received alcohol use disorder treatment, suggesting that medical toxicologists see more severe cases in the acute care setting and have an opportunity to address the underlying use disorder.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/alcalc\/agaf047","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T14:11:47Z","timestamp":1752502307000},"source":"Crossref","is-referenced-by-count":4,"title":["Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016\u20132022"],"prefix":"10.1093","volume":"60","author":[{"given":"John D","family":"DelBianco","sequence":"first","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira J","family":"Galeano","sequence":"additional","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian A","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan M","family":"Surmaitis","sequence":"additional","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E","family":"Shara","sequence":"additional","affiliation":[{"name":"Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Sutter","sequence":"additional","affiliation":[{"name":"Network Office of Research and Innovation, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1255 S. Cedar Crest Blvd., Suite 3200, Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hope","family":"Kincaid","sequence":"additional","affiliation":[{"name":"Network Office of Research and Innovation, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1255 S. Cedar Crest Blvd., Suite 3200, Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J","family":"Stirparo","sequence":"additional","affiliation":[{"name":"Division of Trauma and General Surgery, Institute for Surgical Excellence, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn L","family":"Wheel","sequence":"additional","affiliation":[{"name":"Division of Trauma and General Surgery, Institute for Surgical Excellence, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M","family":"Amaducci","sequence":"additional","affiliation":[{"name":"Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network\/USF Morsani College of Medicine , 1200 S. Cedar Crest Blvd., Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Toxicology Investigators Consortium (ToxIC)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"2025073010191966700_ref1","volume-title":"ACGME Program Requirements for Graduate Medical Education in Medical Toxicology","author":"Accreditation Council for Graduate Medical Education"},{"key":"2025073010191966700_ref2","doi-asserted-by":"publisher","first-page":"e089","DOI":"10.1097\/CCE.0000000000000898","article-title":"Phenobarbital-based protocol for alcohol withdrawal syndrome in a medical ICU: pre-post implementation study","volume":"5","author":"Alwakeel","year":"2023","journal-title":"Crit Care 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