Managing OUD in Acute Care Settings-View Presentation

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Video Summary

The webinar, “Managing OUD in Acute Care Settings,” focused on how to identify, engage, assess, treat, and discharge patients with opioid use disorder (OUD) in hospitals and emergency settings. Dr. Danovich used a case example of JC, a trauma patient with fentanyl exposure, severe pain, PTSD, anxiety, and likely OUD, to show how acute care teams can misread substance use as “medication seeking” and miss serious pain and withdrawal concerns.<br /><br />Key themes included the importance of systematic screening, careful assessment, and avoiding stigma. Dr. Danovich emphasized that language matters: clinicians should use patient-centered terms such as “person with OUD” rather than pejorative labels. He stressed building a therapeutic alliance through validation, respect, and clear goals, because patients often feel threatened or dismissed in acute care settings.<br /><br />The presentation reviewed treatment options for OUD and pain management, especially methadone and buprenorphine. Standard buprenorphine induction, low-dose/micro-induction, and high-dose/macro-induction were explained, along with methadone dosing strategies. He highlighted that patients with OUD often need aggressive multimodal pain control, including NSAIDs, acetaminophen, regional anesthesia, ketamine, and sometimes full agonist opioids, especially around surgery. For patients undergoing procedures, continuing buprenorphine perioperatively is often recommended.<br /><br />Dr. Danovich also covered precipitated withdrawal, symptomatic treatment options, overdose prevention with naloxone, and the importance of discharge planning and linkage to ongoing care such as bridge clinics, OTPs, outpatient care, or residential treatment when appropriate.<br /><br />In the case example, the patient was ultimately treated with methadone.

Keywords

opioid use disorder

acute care

emergency settings

buprenorphine

methadone

pain management

precipitated withdrawal

naloxone

stigma reduction

discharge planning