{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T02:34:11Z","timestamp":1776220451350,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T00:00:00Z","timestamp":1697673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016810","name":"Peter Boris Centre for Addictions Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016810","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007619","name":"Society for Academic Emergency Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Alcohol\u2010related concerns commonly present to the emergency department (ED), with a subset of individuals experiencing the symptoms of an alcohol use disorder (AUD). As such, examining the efficacy of pharmacological anti\u2010craving treatment for AUD in the ED is of increasing interest. The objective of this systematic review was to evaluate the direct evidence assessing the efficacy of providing anti\u2010craving medications for AUD treatment in the ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was conducted according to the patient\u2010intervention\u2010control\u2010outcome question: (P) adults (\u226518\u2009years old) presenting to the ED with an AUD (including suspected AUD); (I) anti\u2010craving medications (i.e., naltrexone, acamprosate, gabapentin); (C) no prescription or placebo; (O) reduction of repeat ED visits, engagement in addiction services, reductions in heavy drinking days, reductions in any drinking and amount consumed (or abstinence), and in relapse. Two reviewers independently assessed articles for inclusion and conducted risk of bias assessments for included studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 143 potentially relevant articles, 6 met inclusion criteria: 3 clinical trials, and 3 case studies. The clinical trials identified evaluated oral versus extended\u2010release naltrexone, monthly extended\u2010release naltrexone injections, and disulfiram. Both oral and extended\u2010release naltrexone resulted in decreased alcohol consumption. Monthly extended\u2010release naltrexone injections resulted in significant improvements in drinking and quality of life. Although out of scope, the disulfiram studies identified did not result in an improvement in drinking in comparison to no medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, there are few studies directly examining the efficacy of anti\u2010craving medications for AUD in the ED, although the limited evidence that exists is supportive of naltrexone pharmacotherapy, particularly extended\u2010release injection formulation. Additional randomized controlled trials are necessary for substantive direct evidence on anti\u2010craving medication initiation in the ED.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14806","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T03:03:40Z","timestamp":1695351820000},"page":"504-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["<scp>SAEM GRACE<\/scp>: Anti\u2010craving medications for alcohol use disorder treatment in the emergency department: A systematic review of direct evidence"],"prefix":"10.1111","volume":"31","author":[{"given":"Kiran","family":"Punia","sequence":"first","affiliation":[{"name":"Department of Psychology, Neuroscience, and Behaviour McMaster University  Hamilton Ontario Canada"},{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare, Hamilton\/McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Scott","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kriti","family":"Manuja","sequence":"additional","affiliation":[{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare, Hamilton\/McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Sabbineni","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitryn","family":"Campbell","sequence":"additional","affiliation":[{"name":"St. Joseph's Healthcare Hamilton  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris M.","family":"Balodis","sequence":"additional","affiliation":[{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare, Hamilton\/McMaster University  Hamilton Ontario Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences McMaster University  Hamilton Ontario Canada"},{"name":"Michael G. DeGroote Centre for Medicinal Cannabis Research McMaster University\/St. Joseph's Healthcare Hamilton  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"MacKillop","sequence":"additional","affiliation":[{"name":"Peter Boris Centre for Addictions Research St. Joseph's Healthcare, Hamilton\/McMaster University  Hamilton Ontario Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences McMaster University  Hamilton Ontario Canada"},{"name":"Michael G. DeGroote Centre for Medicinal Cannabis Research McMaster University\/St. Joseph's Healthcare Hamilton  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Global Status Report on Alcohol and Health 2018","author":"World Health Organization","year":"2018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31310-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00847-9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31775-1"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00406-1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2011-200510"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2014-204581"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/ags035"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100049"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13559"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.181575"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.106128"},{"key":"e_1_2_8_14_1","unstructured":"Government of Canada SC.Mental and substance use disorders in Canada.2013.https:\/\/www150.statcan.gc.ca\/n1\/pub\/82\u2010624\u2010x\/2013001\/article\/11855\u2010eng.htm"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1998.tb02504.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1300\/J465v28n04_01"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1865-1380-4-27"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07069-w"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2010.01297.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-018-0117-1"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.11950"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.1750101"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15357"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.07.018"},{"issue":"5","key":"e_1_2_8_25_1","first-page":"e277","article-title":"First\u2010line medications for alcohol use disorders among public drug plan beneficiaries in Ontario","volume":"63","author":"Spithoff S","year":"2017","journal-title":"Can Fam Physician"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14609"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2012.73.635"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2022.11.013"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14297"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.05.013"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3109\/08039481003686180"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2022.08.453"},{"issue":"9","key":"e_1_2_8_36_1","article-title":"A case for biopsy: injectable naltrexone\u2010induced acute eosinophilic pneumonia","volume":"12","author":"Korpole PR","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/AC.67.4.2170696"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNN.0b013e31829b7a6b"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2006.01581.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000287"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.08.021"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.09.008"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00122-1"},{"issue":"6","key":"e_1_2_8_44_1","first-page":"768","article-title":"The added value of pharmacotherapy to cognitive behavior therapy and vice versa in the treatment of alcohol use disorders: a systematic review","volume":"57","author":"Amsterdam J","year":"2022","journal-title":"Alcohol Alcohol"},{"key":"e_1_2_8_45_1","volume-title":"StatPearls","author":"Stokes M","year":"2022"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243222"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09037-y"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq304"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07862-1"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-2015-2203"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14494"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02093.x"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14806","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T09:17:46Z","timestamp":1715764666000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,19]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/acem.14806"],"URL":"https:\/\/doi.org\/10.1111\/acem.14806","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,19]]},"assertion":[{"value":"2023-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}