#366 Opioid Use Disorder and Acute Pain in the Hospitalized Patient

In this episode of The Curbsiders, Dr. Matthew Watto hosts Drs. Carolyn Chan and Shawn Cohen to discuss managing acute pain in hospitalized patients with opioid use disorder (OUD). They address scenarios involving patients on buprenorphine or methadone maintenance, emphasizing the importance of continuing these medications during hospitalization to manage cravings and prevent withdrawal. The panel explores strategies for pain management, including split dosing of maintenance medications, the use of full agonist opioids, and adjuvant therapies. They also discuss transitioning patients off short-acting opioids upon discharge, the complexities of managing patients using fentanyl, and the potential for low-dose buprenorphine initiation to avoid precipitated withdrawal. The podcast underscores the need for individualized, patient-centered care, balancing pain relief with OUD management, and highlights the importance of community resources and collaborative care with outpatient providers.