Case report: acute care management of severe opioid withdrawal with IV fentanyl.
Acute care
Fentanyl
Inpatient
Opioid use disorder
Pain management
Patient centered care
Withdrawal management
Journal
Addiction science & clinical practice
ISSN: 1940-0640
Titre abrégé: Addict Sci Clin Pract
Pays: England
ID NLM: 101316917
Informations de publication
Date de publication:
05 04 2022
05 04 2022
Historique:
received:
22
10
2021
accepted:
24
03
2022
entrez:
6
4
2022
pubmed:
7
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
An increasing number of individuals who use drugs in North America are preferentially consuming fentanyl over other opioids. This has significant consequences on the treatment and management of opioid use disorder (OUD) and its concurrent disorders, especially in acute care if opioid requirements are not met. We present a patient with severe OUD and daily injection of fentanyl, admitted to hospital for management of acute physical health issues. Due to high opioid requirements and history of patient-initiated discharge, intravenous fentanyl was administered for treatment of opioid withdrawal, and management of pain, which supported continued hospitalization for acute care treatment and aligned with substance use treatment goals. This case demonstrates that intravenous fentanyl for management of OUD in hospital can be a feasible approach to meet opioid requirements and avoid fentanyl withdrawal among patients with severe OUD and daily fentanyl use, thereby promoting adherence to medical treatment and reducing the risk of patient-initiated discharge. There is an urgent need to tailor current treatment strategies for individuals who primarily use fentanyl. Carefully designed research is needed to further explore the use of IV fentanyl for acute care management of severe opioid withdrawal in a hospital setting.
Sections du résumé
BACKGROUND
An increasing number of individuals who use drugs in North America are preferentially consuming fentanyl over other opioids. This has significant consequences on the treatment and management of opioid use disorder (OUD) and its concurrent disorders, especially in acute care if opioid requirements are not met.
CASE PRESENTATION
We present a patient with severe OUD and daily injection of fentanyl, admitted to hospital for management of acute physical health issues. Due to high opioid requirements and history of patient-initiated discharge, intravenous fentanyl was administered for treatment of opioid withdrawal, and management of pain, which supported continued hospitalization for acute care treatment and aligned with substance use treatment goals.
CONCLUSION
This case demonstrates that intravenous fentanyl for management of OUD in hospital can be a feasible approach to meet opioid requirements and avoid fentanyl withdrawal among patients with severe OUD and daily fentanyl use, thereby promoting adherence to medical treatment and reducing the risk of patient-initiated discharge. There is an urgent need to tailor current treatment strategies for individuals who primarily use fentanyl. Carefully designed research is needed to further explore the use of IV fentanyl for acute care management of severe opioid withdrawal in a hospital setting.
Identifiants
pubmed: 35382882
doi: 10.1186/s13722-022-00305-6
pii: 10.1186/s13722-022-00305-6
pmc: PMC8980769
doi:
Substances chimiques
Analgesics, Opioid
0
Narcotics
0
Fentanyl
UF599785JZ
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
22Informations de copyright
© 2022. The Author(s).
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