A Case of Opioid Overdose and Subsequent Death After Medically Supervised Withdrawal: The Problematic Role of Rapid Tapers for Opioid Use Disorder

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Title: A Case of Opioid Overdose and Subsequent Death After Medically Supervised Withdrawal: The Problematic Role of Rapid Tapers for Opioid Use Disorder
Authors: Chang, Derek
Klimas, Jan
Wood, Evan
Fairbairn, Nadia
Permanent link: http://hdl.handle.net/10197/9397
Date: Jan-2018
Abstract: BACKGROUND: Relapse to opioid use is common after rapid opioid withdrawal. As a result, short-term tapers of opioid agonist/partial agonist medications, such as methadone and buprenorphine/naloxone, are no longer recommended by recent clinical care guidelines for the management of opioid use disorder. Nonetheless, rapid tapers are still commonplace in medically supervised withdrawal settings.CASE SUMMARY: We report a case of an individual with opioid use disorder who was prescribed a rapid buprenorphine/naloxone taper in a medically supervised withdrawal facility and who had a subsequent opioid overdose and death after discharge. DISCUSSION:The fatal outcome in this case study underscores the potential severe harms associated with use of rapid tapers. Given the increased overdose risk, tapers should be avoided and continuing care strategies, such as maintenance pharmacotherapy, should be initiated in medically supervised withdrawal settings.
Funding Details: European Commission
Irish Research Council
Type of material: Journal Article
Publisher: Wolters Klumer
Journal: Journal of Addiction Medicine
Volume: 12
Issue: 1
Start page: 80
End page: 83
Copyright (published version): 2018 Wolters Kluwer
Keywords: AddictionDetoxificationBuprenorphineOverdoseOpioid agoinist therapyTaper
DOI: 10.1097/ADM.0000000000000359
Language: en
Status of Item: Peer reviewed
Appears in Collections:Medicine Research Collection

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