Friday, October 29, 2021

Opioid Use Disorder

Taming The SRU - October 28, 2021 - By David Jackson
“The opioid crisis has been well-publicized over the last decade. After a brief decrease in opioid related deaths, there has been a sharp increase since the start of the COVID-19 pandemic. (1,2) Chronic opioid use results in the development of tolerance, requiring larger and larger doses of substance to achieve the same effects. Adaptations in cell physiology in the presence of long-term opioid use results in the syndrome of opioid withdrawal when cessation is attempted. Individuals with opioid use disorder (OUD) who attempt cessation without Medication for Opioid Use Disorder (MOUD) are at high risk for subsequent relapse and potentially fatal overdose. (3) One observational study found significant 1-year mortality (5.5%) in individuals presenting to the emergency department with a non-fatal opioid overdose. (3) Patients receiving treatment for OUD with opioid agonists are more likely to stay in treatment than those receiving non-opioid medications as treatment and have significantly reduced overall mortality compared to patients not receiving MOUD. (4,5) Furthermore, initiation of MOUD from the emergency department is associated with increased retention in treatment for OUD. (6) Below, we will review the presentation of patients to the emergency department with OUD and available treatments for these patients. We will explore using MOUD in the emergency department through a series of clinical scenarios.”