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Review
. 2016 Dec 6;188(17-18):1232-1239.
doi: 10.1503/cmaj.160290. Epub 2016 Sep 19.

Caring for patients with opioid use disorder in the hospital

Joseph H Donroe  1 , Stephen R Holt  2 , Jeanette M Tetrault  2
Affiliations
Review

Caring for patients with opioid use disorder in the hospital

Joseph H Donroe et al. CMAJ. .
No abstract available

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Figures

Figure 1:
Figure 1:
Initiation of methadone or buprenorphine for the treatment of withdrawal in the inpatient setting., *Long-term opioid agonist therapy is preferred and should be encouraged. Methadone should be used with caution in patients with QTc prolongation. †Consider the lower end of the dose range for older adults, adolescents, patients who are using other central nervous system depressants, those otherwise at higher risk for respiratory depression and those whose opioid use is infrequent. Higher initial doses may be needed for patients with higher daily opioid use. ‡Buprenorphine may be administered once a patient is in moderate withdrawal (Clinical Opioid Withdrawal Scale > 12). A combination buprenorphine–naloxone product is available in Canada, and buprenorphine alone can be obtained through Health Canada’s Special Access Programme if necessary. §Methadone doses above 40 mg are rarely needed to treat withdrawal. ¶It is recommended to not exceed buprenorphine 8 mg on day 1 and 16 mg on day 2.
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