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Case Reports
. 2022 Apr 5;17(1):22.
doi: 10.1186/s13722-022-00305-6.

Case report: acute care management of severe opioid withdrawal with IV fentanyl

Pouya Azar  1   2 , Jean N Westenberg  3   4 , Martha J Ignaszewski  3   4   5 , James S H Wong  3   4 , George Isac  6 , Nickie Mathew  3   4   7 , R Michael Krausz  4
Affiliations
Case Reports

Case report: acute care management of severe opioid withdrawal with IV fentanyl

Pouya Azar et al. Addict Sci Clin Pract. .

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.

Keywords: Acute care; Fentanyl; Inpatient; Opioid use disorder; Pain management; Patient centered care; Withdrawal management.

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Conflict of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

References

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