Case report: acute care management of severe opioid withdrawal with IV fentanyl

Azar, Pouya; Westenberg, Jean Nicolas; Ignaszewski, Martha J.; Wong, James S H; Isac, George; Mathew, Nickie; Krausz, Reinhard Michael

doi:10.1186/s13722-022-00305-6

Cited by 6 publications

(3 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with undertreated withdrawal may use their illicit substances and selfdischarge against medical advice, which are strongly associated with adverse outcomes and mortality (66)(67)(68). Some physicians have employed the use of short-acting opioids, like IV hydromorphone and fentanyl, to support patients to stay in hospital and initiate them on OAT (60,65). Although these approaches have been successful, they have not yet been formally recognized as alternatives for withdrawal management in hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

Systematic review on intentional non-medical fentanyl use among people who use drugs

Tsang,

Wong,

Westenberg

et al. 2024

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

ObjectivesFentanyl is a highly potent opioid and has, until recently, been considered an unwanted contaminant in the street drug supply among people who use drugs (PWUD). However, it has become a drug of choice for an increasing number of individuals. This systematic review evaluated intentional non-medical fentanyl use among PWUD, specifically by summarizing demographic variance, reasons for use, and resulting patterns of use.MethodsThe search strategy was developed with a combination of free text keywords and MeSH and non-MeSH keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO. Studies included were human studies with intentional use of non-medical fentanyl or analogues in individuals older than 13. Only peer-reviewed original articles available in English were included.ResultsThe search resulted in 4437 studies after de-duplication, of which 132 were selected for full-text review. Out of 41 papers included, it was found that individuals who use fentanyl intentionally were more likely to be young, male, and White. They were also more likely to have experienced overdoses, and report injection drug use. There is evidence that fentanyl seeking behaviours are motivated by greater potency, delay of withdrawal, lower cost, and greater availability.ConclusionsAmong PWUD, individuals who intentionally use fentanyl have severe substance use patterns, precarious living situations, and extensive overdose history. In response to the increasing number of individuals who use fentanyl, alternative treatment approaches need to be developed for more effective management of withdrawal and opioid use disorder.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021272111.

show abstract

Section: Discussionmentioning

confidence: 99%

Systematic review on intentional non-medical fentanyl use among people who use drugs

Tsang,

Wong,

Westenberg

et al. 2024

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…To date, only few attempts are being made to adapt treatment options to the challenges posed by the high potency of fentanyl relative to heroin. 20 This is due in part to legal restrictions and a perennial lack of resources, despite a prolonged public health crisis.…”

Section: The Current State Of Care For Substance Use Disordersmentioning

confidence: 99%

A Call for an Evidence-Based Strategy Against the Overdose Crisis

Krausz,

Westenberg,

Tai

et al. 2023

Can J Psychiatry

Self Cite

View full text Add to dashboard Cite

“…The increasing significance of fentanyl does not only require reshaping and expanding existing health services but also requires new innovative developments and novel treatment approaches. 5 , 6 This includes the adaptation of health services to evolving substance use patterns. Given today’s opioid use patterns being dominated by fentanyl, evaluating a novel treatment option called fentanyl-assisted treatment, which is analogous to heroin-assisted treatment, has been suggested in order to adequately address the needs of individuals with illicit fentanyl use and reduce barriers to treatment.…”

Section: Applying the Cssf Factors To The Fentanyl System Shockmentioning

confidence: 99%

The Fentanyl System Shock – Are There Lessons to Learn From the COVID-19 System Shock Framework?; Comment on "The COVID-19 System Shock Framework: Capturing Health Sys-tem Innovation During the COVID-19 Pandemic"

Meyer

Westenberg

Krausz

2023

Int J Health Policy Manag

Self Cite

View full text Add to dashboard Cite

The Sydney Children’s Hospitals Network addressed the challenges of the COVID-19 pandemic by implementing innovative changes which made their health system resilient and responsive. For other health care systems, there are important takeaways. In the US and Canada, an urgent widespread response is needed to address the overdose crisis, driven by potent synthetic opioids (i.e., fentanyl and its derivates). We project the COVID-19 System Shock Framework on to the North American healthcare systems and suggest a Fentanyl System Shock Framework, which provides a framework for necessary changes and innovations to address the overdose crisis. To become resilient to the fentanyl system shock, core components as well as overarching values, health policy, and online technologies need to be adapted to reduce the death count and meet the evolving needs of marginalised individuals who use opioid. Future research should focus on scientifically assessing such implementations to guide evidence-based decision making.

show abstract

Case report: acute care management of severe opioid withdrawal with IV fentanyl

Cited by 6 publications

References 43 publications

Systematic review on intentional non-medical fentanyl use among people who use drugs

Systematic review on intentional non-medical fentanyl use among people who use drugs

A Call for an Evidence-Based Strategy Against the Overdose Crisis

The Fentanyl System Shock – Are There Lessons to Learn From the COVID-19 System Shock Framework?; Comment on "The COVID-19 System Shock Framework: Capturing Health Sys-tem Innovation During the COVID-19 Pandemic"

Contact Info

Product

Resources

About