Opioid use disorder: Difference between revisions

Revision as of 19:24, 9 July 2020

A substance use disorder involving heroin, fentanyl, or other opioid medications

The risk of OUD among patients treated with opioids for chronic pain is around 8 to 30%

First give boluses of naloxone 0.04mg to 0.08mg IV to improve respiratory depression escalated quickly q2-3 minutes up to 0.4, 2, 4, 10, 15mg (start low and go fast)
Then start infusion of 2/3 the effective dose per hour
QRS and QT lengthening by blocking Na and K channels
- May need repeated defibrillation, overdrive pacing, or ECMO

Follow safe prescribing practices
Risk assessment
- Consider their personal and family history of psychiatric illness and substance use disorder
- Consider their social history, including their living situation, safety of housing, personal safety, children or dependents, and social supports
- Can use tools such as the opioid risk tool or SOAPP-R as a more formal risk assessment

@@ Line 23: / Line 23: @@
 *[[Methadone]] second-line
 *Slow-release opioids such as [[Kadian]] third-line
+== Prevention ==
+* Follow safe prescribing practices
+* Risk assessment
+** Consider their personal and family history of psychiatric illness and substance use disorder
+** Consider their social history, including their living situation, safety of housing, personal safety, children or dependents, and social supports
+** Can use tools such as the [[opioid risk tool]] or [[SOAPP-R]] as a more formal risk assessment
 ==Further Reading==