Alcohol Withdrawal Throwdown: Benzos vs Barbs

Alcohol withdrawal is one of the most challenging presentations we face in the emergency department. These patients are often very sick and simultaneously very difficult to manage. Is the solution to go big or go home with benzodiazepines? Or does the resurgence of phenobarbital usher in a new era in alcohol withdrawal management? With patient safety, sedation risk, and resource utilization all hanging in the balance, this is more than an esoteric pharmacologic debate—it's a frontline dilemma.

This Meeting of the Minds session brings the controversy to center stage. Two expert clinicians go head-to-head, each armed with a pivotal article and their real-world experience. One defends the traditional benzodiazepine-first approach rooted in decades of use, while the other makes the case for phenobarbital-based strategies, citing new evidence and shifting trends.

After brief article presentations, the moderator will ignite a dynamic, case-based debate that dives into efficacy, safety, ICU admission risk, and practical application in the high-stakes environment of emergency care. Expect spirited dialogue, sharp insights, and take-home pearls. They will even delve into the controversies surrounding adjunctive agents like ketamine and dexmedetomidine.

The session will conclude with an extended audience Q&A, inviting participants to challenge the experts, share institutional successes (or missteps), and weigh in on what’s working in their own practice.