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Intravenous Fentanyl for Symptom Management in Hospitalized Patients With Refractory Opioid Withdrawal: A
Hospitalized patients with severe opioid use disorder (OUD) and refractory withdrawal were treated with intravenous fentanyl. This approach may help manage challenging opioid withdrawal symptoms, with most patients receiving medication for opioid use disorder upon discharge.
Area of Science:
- Addiction Medicine
- Pharmacology
- Critical Care
Background:
- Potent synthetic opioids contribute to increasingly severe and difficult-to-treat opioid withdrawal syndromes.
- Hospitalized patients with opioid use disorder (OUD) often present with complex and refractory withdrawal symptoms.
Purpose of the Study:
- To describe patient characteristics and short-term treatment outcomes for hospitalized individuals with OUD treated with intravenous fentanyl for opioid withdrawal.
- To evaluate the safety and efficacy of intravenous fentanyl in managing refractory opioid withdrawal.
Main Methods:
- Retrospective cohort study of inpatients with fentanyl use disorder and refractory opioid withdrawal.
- Data collected on sociodemographics, substance use, fentanyl dosing, and treatment outcomes.
- Safety outcomes included opioid toxicity and transfer to higher care levels.
Main Results:
- Fifty-nine patient encounters were analyzed; 56% of patients were hospitalized with infection.
- Intravenous fentanyl doses ranged from 250-5000 mcg, with a median treatment duration of 9 days.
- 80% of patients received a medication for opioid use disorder (MOUD) prescription at discharge; 19% experienced opioid toxicity.
Conclusions:
- Prescribed intravenous fentanyl can aid in managing refractory opioid withdrawal for hospitalized patients with severe OUD.
- Further research is needed to develop effective strategies for patients with tolerance to fentanyl and other high-potency opioids.
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