A Case of Opioid Overdose and Subsequent Death After Medically Supervised Withdrawal: The Problematic Role of Rapid Tapers for Opioid Use Disorder.

J Addict Med

British Columbia Centre on Substance Use, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada (DCC, JK, EW, NF); Department of Family Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada (DCC); School of Medicine, University College Dublin, Belfied, Dublin, Ireland (JK); and Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada (EW, NF).

Published: April 2019

Background: Relapse to opioid use is common after rapid opioid withdrawal. As a result, short-term tapers of opioid agonist/partial agonist medications, such as methadone and buprenorphine/naloxone, are no longer recommended by recent clinical care guidelines for the management of opioid use disorder. Nonetheless, rapid tapers are still commonplace in medically supervised withdrawal settings.

Case Summary: We report a case of an individual with opioid use disorder who was prescribed a rapid buprenorphine/naloxone taper in a medically supervised withdrawal facility and who had a subsequent opioid overdose and death after discharge.

Discussion: The fatal outcome in this case study underscores the potential severe harms associated with use of rapid tapers. Given the increased overdose risk, tapers should be avoided and continuing care strategies, such as maintenance pharmacotherapy, should be initiated in medically supervised withdrawal settings.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786466PMC
http://dx.doi.org/10.1097/ADM.0000000000000359DOI Listing

Publication Analysis

Top Keywords

medically supervised
16
supervised withdrawal
16
rapid tapers
12
opioid disorder
12
opioid overdose
8
tapers opioid
8
opioid
7
withdrawal
5
rapid
5
tapers
5

Similar Publications

Background And Importance: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.

View Article and Find Full Text PDF

Traditional sedatives like Propofol can lead to adverse effects. This study compares the safety and efficacy of Ciprofol monotherapy versus combined Propofol for painless gastroscopy. Patients underwent painless gastroscopy at our hospital from January 2023 to December 2023 were studied.

View Article and Find Full Text PDF

Background: Since the inception of the ASHAs in the year 2005, their work horizons have increased from Reproductive, Maternal, Newborn, Child, and Adolescent health (RMNCH + A), Communicable and Non-Communicable Diseases (CD & NCD) to oral health, ophthalmologic care, and other supportive community level healthcare services. The present literature lacks comprehensive understanding and synthesis of domain-wise knowledge of ASHAs and the factors affecting their knowledge. Therefore, this study aimed to synthesize and collate the relevant evidence to understand the overall knowledge of ASHAs.

View Article and Find Full Text PDF

A prediction study on the occurrence risk of heart disease in older hypertensive patients based on machine learning.

BMC Geriatr

January 2025

Department of Cardiology, The Second Hospital & Clinical Medical School, Lanzhou University, No. 82 Cuiyingmen, Lanzhou, 730000, China.

Objective: Constructing a predictive model for the occurrence of heart disease in elderly hypertensive individuals, aiming to provide early risk identification.

Methods: A total of 934 participants aged 60 and above from the China Health and Retirement Longitudinal Study with a 7-year follow-up (2011-2018) were included. Machine learning methods (logistic regression, XGBoost, DNN) were employed to build a model predicting heart disease risk in hypertensive patients.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic is a global crisis, and health systems worldwide have faced numerous challenges in containing it. This study aimed to identify the challenges faced by the Iranian health system in controlling the COVID-19 pandemic.

Methods: A conventional content analysis approach was employed in this qualitative study.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!