Methadone Maintenance Therapy Can Be Initiated While Patients Are Hospitalized

Objective: To examine the evidence behind commonly held beliefs and common practices for reducing waste in health care. Discussion: Opioid use disorder (OUD) is a condition that is becoming more frequently encountered by hospitalists, particularly based on recognition as well as treatment options. In the United States, methadone is a medication useful for treatment of OUD; it is a long-acting mu-receptor agonist that takes several days to reach steady state. Drug interactions are common, with concerns about QTc prolongation. In the outpatient setting, methadone must be dispensed only in opioid treatment programs (OTPs), with rare exceptions, and thus is not a prescription that can be written upon discharge for continuity in the traditional sense. However, per federal regulations, hospitalized patients can be treated with methadone for acute opioid withdrawal symptoms (OWS), and can also have their existing dosing initiated or adjusted while admitted for another condition. There is go more...