Hospitalized Patients

The management of opioid dependent individuals hospitalized for medical or surgical reasons remains controversial. It is generally agreed that detoxification from opioids during the acute course of a medical illness is usually unsuccessful. Alleviation of withdrawal symptoms should be the goal of therapy. Daily administration of a verified dose of methadone orally (or half the verified dose intramuscularly if the patient is to take nothing by mouth) is recommended to inhibit withdrawal symptoms and reduce craving. This applies only to individuals who are actively enrolled in a methadone maintenance program and in whom the dose can be verified externally. The habitual user who is not on methadone maintenance therapy can receive methadone 20 mg by mouth (PO) or 10 mg IM. These dosages should inhibit withdrawal symptoms but not induce euphoria. No methadone should be administered to the habitual user until the appearance of withdrawal symptoms.

Occasionally, patients will present to the ED requesting methadone because they missed their outpatient or community program appointment. Unless the provider or clinic can be contacted and they indicate that the request is appropriate and valid, it should not be honored. Indiscriminate dispensing of methadone undermines methadone maintenance programs. Similarly, it is difficult to think of any valid rationale to prescribe methadone for outpatient use from the ED. In fact, pharmacies will generally not honor methadone prescriptions written on standard ED prescription pads. The Drug Enforcement Administration (DEA) rigidly controls how methadone is prescribed. Methadone prescriptions for detoxification programs (maximum 3 days) and maintenance therapy (longer than 3 days), can be filled only at methadone clinics sanctioned by the DEA. Reprimand and even loss of license to practice medicine has occurred for violations.

Body Detox Made Easy

Body Detox Made Easy

What exactly is a detox routine? Basically a detox routine is an all-natural method of cleansing yourbr body by giving it the time and conditions it needs to rebuild and heal from the damages of daily life and the foods you eat and other substances you intake. There are many different types of known detox routines.

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