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Focus Session

Phenobarbital Protocols on Trial: A Point–Counterpoint Debate

Saturday, April 25, 2026
4:45 PM - 6:00 PM PT
Location: Seaport Ballroom, Level 2

    Presenter(s)

  • Robert Cole Pueringer, MD

    Addiction Medicine, Medical Toxicology; Medical Director of Substance Use and Addiction Care Program
    Essentia Health
    Duluth, Minnesota

    Slides

  • Timothy J. Wiegand, MD, DFACMT, FAACT, DFASAM

    Director of Medicine, Toxicology and Addiction Consulting PLLC and CMO Toxicology Consults
    Medicine Toxicology & Addiction Consulting PLLC
    University of Rochester School of Medicine & Dentistry
    Rochester, New York

  • JoAn Laes, MD

    Addiction Physician
    Allina
    Minneapolis, Minnesota

  • Evan S. Schwarz, MD, FASAM

    Clinical Professor of Emergency Medicine, Medical Toxicology Fellowship Director
    UCLA
    Los Angeles, California

    • Non-presenting author(s)

  • Lewis S. Nelson, MD, MBA

    Professor of Emergency Medicine and Medical Toxicology
    Florida Atlantic University College Of Medicine
    Delray Beach, Florida

  • Jeremiah D. Fairbanks, DO

    Physician
    Allina
    Inver Grove Heights, Minnesota

  • KK

    Katie Krieger, MD

    Emergency Medicine physician, Addiction Medicine fellow
    University of Minnesota
    Minneapolis, Minnesota

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.

Learning Objectives:

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.
Disclosure(s):
Robert Cole Pueringer, MD: No financial relationships to disclose
Timothy J. Wiegand, MD, DFACMT, FAACT, DFASAM: No financial relationships to disclose
JoAn Laes, MD: No financial relationships to disclose
Evan S. Schwarz, MD, FASAM: No financial relationships to disclose
Lewis S. Nelson, MD, MBA: No financial relationships to disclose
Jeremiah D. Fairbanks, DO: No financial relationships to disclose
Katie Krieger, MD: No financial relationships to disclose