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Case report: acute care management of severe opioid withdrawal with IV fentanyl Azar, Pouya; Westenberg, Jean; Ignaszewski, Martha J.; Wong, James S. H.; Isac, George; Mathew, Nickie; Krausz, Michael, MD, PhD, FRCPc

Abstract

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.

Item Metadata

Title
Case report: acute care management of severe opioid withdrawal with IV fentanyl
Creator
Azar, Pouya; Westenberg, Jean; Ignaszewski, Martha J.; Wong, James S. H.; Isac, George; Mathew, Nickie; Krausz, Michael, MD, PhD, FRCPc
Contributor
British Columbia Centre on Substance Use; Vancouver General Hospital; Children's Hospital (Vancouver, B.C.); Provincial Health Services Authority (B.C.)
Publisher
BioMed Central
Date Issued
2022-04-05
Description
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.
Subject
Fentanyl; Opioid use disorder; Withdrawal management; Pain management; Acute care; Patient centered care; Inpatient
Genre
Article
Type
Text
Language
eng
Date Available
2022-05-20
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0413671
URI
http://hdl.handle.net/2429/81614
Affiliation
Medicine, Faculty of; Non UBC; Anesthesiology, Pharmacology and Therapeutics, Department of; Psychiatry, Department of
Citation
Addiction Science & Clinical Practice. 2022 Apr 05;17(1):22
Publisher DOI
10.1186/s13722-022-00305-6
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

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Rights

Attribution 4.0 International (CC BY 4.0)