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The SAEM GRACE\u20104 Writing Team, composed of emergency physicians and experts in addiction medicine and patients with lived experience, applied the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding six priority questions for adult ED patients with AWS, AUD, and CHS. The SAEM GRACE\u20104 Writing Team reached the following recommendations: (1) in adult ED patients (over the age of 18) with moderate to severe AWS who are being admitted to hospital, we suggest using phenobarbital in addition to benzodiazepines compared to using benzodiazepines alone [\n                    <jats:italic>low to very low certainty of evidence<\/jats:italic>\n                    ]; (2) in adult ED patients (over the age of 18) with AUD who desire alcohol cessation, we suggest a prescription for one anticraving medication [\n                    <jats:italic>very low certainty of evidence<\/jats:italic>\n                    ]; (2a) in adult ED patients (over the age of 18) with AUD, we suggest naltrexone (compared to no prescription) to prevent return to heavy drinking [\n                    <jats:italic>low certainty of evidence<\/jats:italic>\n                    ]; (2b) in adult ED patients (over the age of 18) with AUD and contraindications to naltrexone, we suggest acamprosate (compared to no prescription) to prevent return to heavy drinking and\/or to reduce heavy drinking [\n                    <jats:italic>low certainty of evidence<\/jats:italic>\n                    ]; (2c) in adult ED patients (over the age of 18) with AUD, we suggest gabapentin (compared to no prescription) for the management of AUD to reduce heavy drinking days and improve alcohol withdrawal symptoms [\n                    <jats:italic>very low certainty of evidence<\/jats:italic>\n                    ]; (3a) in adult ED patients (over the age of 18) presenting to the ED with CHS we suggest the use of haloperidol or droperidol (in addition to usual care\/serotonin antagonists, e.g., ondansetron) to help with symptom management [\n                    <jats:italic>very low certainty of evidence<\/jats:italic>\n                    ]; and (3b) in adult ED patients (over the age of 18) presenting to the ED with CHS, we also suggest offering the use of topical capsaicin (in addition to usual care\/serotonin antagonists, e.g., ondansetron) to help with symptom management [\n                    <jats:italic>very low certainty of evidence<\/jats:italic>\n                    ].\n                  <\/jats:p>","DOI":"10.1111\/acem.14911","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T05:17:13Z","timestamp":1715750233000},"page":"425-455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE\u20104): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6426-824X","authenticated-orcid":false,"given":"Bjug","family":"Borgundvaag","sequence":"first","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health System, Department of Family and Community Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-4750","authenticated-orcid":false,"given":"Fernanda","family":"Bellolio","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4185-3363","authenticated-orcid":false,"given":"Isabelle","family":"Miles","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5015-2457","authenticated-orcid":false,"given":"Evan S.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-0308","authenticated-orcid":false,"given":"Sameer","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Critical &amp; Emergency Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5211-5334","authenticated-orcid":false,"given":"Mark K.","family":"Su","sequence":"additional","affiliation":[{"name":"The Ronald O. 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