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High-dose intravenous hydromorphone for patients who use opioids in the hospital setting: time to reduce the barriers Labonté, Laura; Young, Samantha

Abstract

Abstract Individuals who use opioids have higher rates of hospitalization compared to the general population. Insufficiently treated withdrawal and pain are major factors contributing to high rates of self-initiated hospital discharges (also referred to as leaving against medical advice) in this population. While injectable opioid agonist therapy is limited or unavailable in the majority of Canadian communities, intravenous hydromorphone (IV HM) is widely available in the hospital setting and high-dose IV HM may be a useful treatment adjunct to improve comfort and engagement in inpatient care for some individuals who use opioids. However, major barriers to its use exist including lack of comfort amongst healthcare providers and hospital policies restricting administration. In this commentary, we highlight the potential usefulness of high-dose IV HM as a treatment adjunct for individuals who use opioids in the hospital setting and advocate for expanded hospital policies to facilitate its use.

Item Metadata

Title
High-dose intravenous hydromorphone for patients who use opioids in the hospital setting: time to reduce the barriers
Creator
Labonté, Laura; Young, Samantha
Contributor
St. Paul's Hospital (Vancouver, B.C.); Providence Health Care (Vancouver, B.C.). Addiction Medicine
Publisher
BioMed Central
Date Issued
2021-08-13
Description
Abstract Individuals who use opioids have higher rates of hospitalization compared to the general population. Insufficiently treated withdrawal and pain are major factors contributing to high rates of self-initiated hospital discharges (also referred to as leaving against medical advice) in this population. While injectable opioid agonist therapy is limited or unavailable in the majority of Canadian communities, intravenous hydromorphone (IV HM) is widely available in the hospital setting and high-dose IV HM may be a useful treatment adjunct to improve comfort and engagement in inpatient care for some individuals who use opioids. However, major barriers to its use exist including lack of comfort amongst healthcare providers and hospital policies restricting administration. In this commentary, we highlight the potential usefulness of high-dose IV HM as a treatment adjunct for individuals who use opioids in the hospital setting and advocate for expanded hospital policies to facilitate its use.
Subject
Intravenous administration; Opiate substitution treatment; Hydromorphone; Hospitalization
Genre
Article
Type
Text
Language
eng
Date Available
2021-09-02
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0401869
URI
http://hdl.handle.net/2429/79604
Affiliation
Medicine, Faculty of; Non UBC; Psychiatry, Department of
Citation
Harm Reduction Journal. 2021 Aug 13;18(1):87
Publisher DOI
10.1186/s12954-021-00533-0
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

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Attribution 4.0 International (CC BY 4.0)