ED Toolkit for Alcohol-Related Presentations
This toolkit was created for ED providers, including counsellors, nurses, nurse practitioners, peer support workers, pharmacists, physicians, and social workers. These tools address the effective treatment of alcohol withdrawal, management of other alcohol-related presentations, brief counselling interventions, initiation of anti-craving medications, and referral to community resources. The tools include evidence-informed recommendations, order sets, algorithms, sample prescriptions, and patient materials.
The recommendations provided in this toolkit are intended for informational purposes only. The recommendations in these documents represent the views of the authors, arrived at after careful consideration of the available scientific evidence and external expert peer review. Best efforts were made to ensure that the information in this set of documents is accurate. Clinicians and other readers must determine the appropriate clinical care for each individual patient on the basis of all the clinical data available for the individual case. The META:PHI program at Women’s College Hospital and every person involved in the creation of this publication disclaim any warranty as to the accuracy, completeness, or currency of this publication. Guideline users are always urged to seek out the most current information available that might impact the recommendations contained within a guideline. The META:PHI program at Women’s College Hospital expressly disclaims any responsibility or liability for damages, loss, injury, or liability resulting from reliance on information within this guide.
Download the entire ED Toolkit for Alcohol-Related Presentations
Download the Introduction to the ED Toolkit for Alcohol-Related Presentations
Recommendations
These recommendations for the management of alcohol-related emergency department (ED) presentations were developed by a group of people with professional and/or experiential expertise of alcohol use.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
A summary of recommendations of how to manage alcohol-related emergency department (ED) presentations.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Selected special considerations to keep in mind when providing care to emergency department (ED) patients with alcohol-related presentations.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 28 March 2025
Order Sets and Algorithms
An order set for managing alcohol withdrawal in the emergency department (ED).
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 28 March 2025
An algorithm for choosing an anti-craving medication for emergency department (ED) patients.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
A flow sheet outlining an approach to patients presenting to the emergency department (ED) with an alcohol-related concern.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Discharge
An alcohol withdrawal management prescription template (for gabapentin, diazepam, or lorazepam) for patients being discharged from the emergency department (ED)
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
An anti-craving prescription template for patients being discharged from the emergency department (ED).
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
A template for a discharge note to primary care after a client has been started on naltrexone in withdrawal management.
Part of WMS Toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on acamprosate in withdrawal management.
Part of WMS Toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on gabapentin in withdrawal management.
Part of WMS Toolkit
Version date: 25 January 2024
Patient-Facing Documents
An emergency department (ED) waiting room poster that encourages patients to talk about their substance use.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
A handout for patients attending the emergency department (ED) for an alcohol-related concern
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Training
An e-learning module for emergency department (ED) providers on using the Clinical Institute Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) assessment to measure alcohol withdrawal in the emergency department (ED)
Created by the Centre for Addiction and Mental Health (CAMH)
A training tool on conducting a Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) assessment to measure alcohol withdrawal in the emergency department (ED).
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Sample Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) assessment.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
An overview of delivering a brief negotiated interview (BNI) for alcohol use in the emergency department (ED).
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Sample brief negotiated interview (BNI) for alcohol use in the ED.
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 15 December 2023
Information for emergency department (ED) staff on how language, behaviour, and attitudes can convey stigma towards people who use drugs.
Part of ED Toolkit for OUD
Part of ED Toolkit for Alcohol-Related Presentations
Version date: 29 April 2025
Robert Blackwell, Community Consultant
Bjug Borgundvaag MD PhD CCFP(EM)
Katie Dunham NP
Charlene Fraser, Community Consultant
Ruben Hummelen MD PhD CCFP
Meldon Kahan MD CCFP FRCPC
Kate Lazier MD CCFP(EM)
Robyn Nocilla BScN MSc NP-PHC
Kelly Shillington RN MScN ENC(C)
Ginette Thivierge RN, Community Consultant
Marcel Wagner RPh
Jennifer Wyman MD MPH
Chris Chan RPh
Janelle Hannon MSW RSW
Christina Henry BA BScN RN
Laura Jones NP
Michelle Klaiman MD FRCPC(EM)
Justin J. Koh MD MPH FRCPC
Bryan Marshall SSW, Community Consultant
Adam McInnis RN BScN MScCH MN-NP (student), Community Consultant
Patrick Nowak RN BScN
Lori Regenstreif MD CCFP(AM)
Julie Samson MD CCFP(EM)
Hasan Sheikh MD CCFP(EM)
Elizabeth Shouldice MD CCFP(AM)
Anita Srivastava MD MSc