Phenobarbital Protocols on Trial: A Point-Counterpoint Debate
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Phenobarbital Protocols on Trial: A Point-Counterpoint Debate
Recorded: Thursday, April 23, 2026 to Sunday, April 26, 2026
On-Demand Session
Overview
This 75-minute on-demand session from the ASAM 57th Annual Conference addresses phenobarbital protocols for alcohol withdrawal through point-counterpoint debate, comparing pharmacologic strategies and institutional implementation approaches.
Phenobarbital has re-emerged as a popular choice for management of alcohol withdrawal syndrome, yet practice remains divided between phenobarbital-first, benzodiazepine-first, and combination regimens. This Focus Session features an expert debate exploring the evidence, safety, and systems-level implications of each approach. Faculty in addiction medicine and medical toxicology will present opposing perspectives and rebuttals, guiding participants through current data, pharmacologic principles, and clinical outcomes to help clarify how best to integrate phenobarbital protocols across acute care and outpatient settings.
The target audience for this Intermediate level session includes physicians, nurse practitioners, physician assistants, other clinicians, researchers, residents, fellows, and students.
This session addresses the following ACGME Competencies: Patient Care and Procedural Skills, Medical Knowledge.
This session addresses the following IPEC Competencies: Roles and Responsibilities, Teams and Teamwork.
Learning Objectives
Upon completion, learners will be able to:
- Compare the pharmacologic principles, efficacy data, and safety considerations of phenobarbital, benzodiazepine, and non-benzodiazepine-based protocols for alcohol withdrawal syndrome.
- Evaluate clinical scenarios and patient factors that inform selection of monotherapy, combination, or hybrid "benzodiazepine-sparing" strategies.
- Apply evidence-informed principles to develop or refine alcohol withdrawal syndrome management protocols suited to their institutional resources and patient populations.
Registration Rates
| Rate Description | Rate |
| ASAM Member | $29 |
| Non-Member | $39 |
| Associate Member | $19 |
| Resident Member* | $19 |
| Student Member* | $19 |
*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.
Membership Question? Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.
Refunds & Cancellations
All ASAM eLearning Center refund requests must be made in writing to education@asam.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or e-Learning Center credit. Automatic full refunds will be made for any course with a live-course component that has been cancelled.
Registration Open: 05/25/2026 - 04/25/2029
User Access Closed: 05/25/2029
Course Instructions
- Click on the Contents tab to watch the on-demand recording.
- Click Complete Post Test to answer multiple choice questions. You will have 10 attempts to pass and must answer 4 out of 5 questions correctly.
- Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
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Robert Pueringer
MD
Robert "Cole" Pueringer, MD, CTropMed: I am an Internist/Hospitalist, Medical Toxicologist, and currently an Addiction Medicine Fellow at the University of Minnesota. Originally from Montana but all my medical training has been in the Minnesota. I completed Medical School at the University of Minnesota Twin Cities (2015), Internal Medicine Residency at Hennepin County Medical Center (Hennepin Healthcare) (2018), and a Medical Toxicology Fellowship at HealthPartners Institute/HCMC (2021). Interists include the overlap of Toxicology Addiction, Global Health, and SUD in healthcare professionals. I enjoy ourdoor recreation, soccer, and engagement in the recovery community.
Timothy Wiegard
MD
Dr. Wiegand holds board certification in internal medicine, medical toxicology and clinical pharmacology. He completed his Postgraduate Fellowships in Medical Toxicology and Clinical Pharmacology at the University of California, San Francisco in 2006. His current position is as the Director of Toxicology at the University of Rochester Medical Center in Rochester, New York where he holds an appointment in Emergency Medicine as Associate Clinical Professor of Emergency Medicine at Strong Memorial Hospital and Highland Hospital. In addition to his positions at the University of Rochester Dr. Wiegand Directs the Toxicology Consult Service at Strong Memorial and Highland Hospitals, serves as Medical Director of Huther-Doyle Chemical Dependency treatment program in Rochester, NY, and treats acute alcohol and opioid withdrawal at the Syracuse Behavioral Health (SBH) Rochester detoxification facility. He is also faculty for the SUNY Upstate Medical Toxicology Fellowship training program and serves as on-call toxicologist for the SUNY Upstate Poison Center. Dr. Wiegand directs a clinical rotation in medical toxicology for the Strong Memorial Hospital Emergency Medicine residency program and is involved in toxicology, pharmacology and addiction medicine education for fellows, residents, and students in pharmacy and medicine. His interests include the treatment of acute intoxication and treatment of alcohol, opioid and other drug withdrawal syndromes and in the treatment and prevention of addiction and dependence. He has been treating opioid dependence since 2005 as an SAMHSA-waived OBOT provider. Dr. Wiegand has published in the areas of acute intoxication, withdrawal and treatment and prevention of drug overdose and in medical education in toxicology and emergency medicine and in the development, billing and reimbursement related to clinical toxicology practice. He is a section editor for the Encyclopedia of Toxicology, 3rd edition and has published numerous journal articles and textbook chapters on toxicology and related topics. Dr. Wiegand won the 2013 American Society of Addiction Medicine (ASAM) Annual MedSci research award for best abstract for research involving addiction medicine education during medical toxicology fellowship training. Dr. Wiegand is the Chair for the American College of Medical Toxicology (ACMT) Addiction Medicine section and he was appointed to the New York chapter of the American Society of Addiction Medicine (NYSAM) Board of Governors as Communication Committee Chair and Board Member in 2013. He has been increasingly active in ASAM and in his state chapter, NYSAM, since 2011.
JoAn Laes
MD
JoAn Laes, MD is an addiction medicine physician and consulting medical toxicologist. Her focus is inpatient addiction medicine and toxicology consultation, and outpatient treatment of opioid and other substance use disorders. She is an owner at Twin Cities Toxicology, providing consultation, medical directorship, and expert opinion in the fields of addiction medicine and medical toxicology. She is board-certified in Internal Medicine, Addiction Medicine, and Medical Toxicology. She completed an internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota. She has spoken nationally on the subjects of addiction medicine and toxicology.
No relevant financial relationships
Evan Schwarz
MD
Dr. Evan Schwarz is an Assistant Professor of Emergency Medicine at the Washington University School of Medicine in Saint Louis. He is the Medical Toxicology section chief and directs their inpatient and outpatient clinical services. This includes managing inpatients with substance use disorders as well as following them in the outpatient toxicology and addiciton medicine clinic. In addiction to his clinical activities, he is a core faculty member of the emergency medicine residency, the Vice President for the Missouri College of Emergency Physicians, and a member of the Board of Directors for the American College of Medical Toxicology.
Lewis Nelson
MD, FACEP, FACMT, DFASAM
Lewis Nelson, MD, FACEP, FACMT, DFASAM is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is a member of the Board of Directors of the American Board of Emergency Medicine and a Past-President of the American College of Medical Toxicology. He remains actively involved with the CDC, FDA, DHS, and several professional medical organizations, including ASAM. Dr. Nelson is an editor of the textbook Goldfrank’s Toxicologic Emergencies and on the editorial boards of several journal.
No Relevant Financial Disclosures
Jeremiah D. Fairbanks
DO
Jeremiah Fairbanks, DO is a current addiction medicine fellow at the University of Minnesota. He completed his medical training at Des Moines University followed by a family medicine residency through the University of Minnesota. He has helped develop programs treating office based opioid use disorder through primary care in southern Minnesota and has his family medicine board certification.
Katie Krieger, MD
Emergency Medicine physician, Addiction Medicine fellow
University of Minnesota
Accreditation & Credit Designation Statements
Joint Accreditation Statement
In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
This activity awards 1.25 Nursing contact hours.
Pharmacology Hours
This activity has 1.25 hour(s) that satisfy the requirements for NP and PA Pharmacology Hours.
PAs
ASAM has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1.25 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.25 AAPA Category 1 CME credits. Approval is valid until 05/25/2029. PAs should only claim credit commensurate with the extent of their participation.
Social Workers
As a Jointly Accredited Organization, ASAM is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.25 general continuing education credits.
IPCE Credit
This activity was planned by and for the healthcare team, and learners will receive 1.25 Interprofessional Continuing Education (IPCE) credits for learning and change.
California Association for Drug/Alcohol Educators (CAADE)
This educational program is approved by CAADE: #CP40 999 1225.
California Association of DUI Treatment Centers (CADTP)
This educational program is approved by CADTP: #205.
California Consortium of Addiction Programs and Professionals (CCAPP)
This educational program is approved by CCAPP: # OS-20-330-0227.
Other Professions - Continuing Education Credits (CEUs)
Upon completion of the activity and online evaluation, all other participants may request a certificate of participation. Participants may submit this certificate of participation to their professional organization/institute as documentation for completing this accredited continuing activity.
Maintenance of Certification (MOC) or Continuing Certification Programs (CCP)
This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABIM, ABP and ABS. By completing the online credit claim and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.
American Board of Anesthesiology (ABA)
This activity offers up to 1.25 CME credits, of which 1.25 credits contribute the patient safety CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.
Maintenance of Certification in Anesthesiology® and MOCA® are registered certification marks of the American Board of Anesthesiology®
American Board of Internal Medicine (ABIM)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 Medical Knowledge MOC points and patient safety MOC credit in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
American Board of Pediatrics (ABP)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.25 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.
American Board of Preventive Medicine (ABPM)
This activity has been designed to satisfy the Lifelong Professional Development requirements of The American Board of Preventive Medicine’s Continuing Certification (CCP) requirements. These credits are not reported directly to ABPM. Please save your certificate for your records.
American Board of Psychiatry and Neurology (ABPN)
This activity has been designed to satisfy the CME requirements of the American Board of Psychiatry and Neurology’s Continuing Certification (CC) requirements. These credits are not reported directly to ABPN. Please save your certificate for your records.
American Board of Surgery (ABS)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
Royal College of Physicians and Surgeons of Canada (RCPSC)
The Royal College of Physicians and Surgeons of Canada will recognize activities registered for CME for MOC as meeting the requirements for Royal College MOC Program Section 3 (Self-Assessment Programs) credits. Visit CME that Counts for Royal College MOC for more information.
Disclosure Information
In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education. Click here to view the full disclosure listing.
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