In critical care, we’ve been treating patients with opioid use disorder for a long time. If they’re intubated for intoxication, we extubate them and send them home. If they’re septic with endocarditis, we treat their sepsis. Unfortunately, this isn’t enough. We’re treating the complications of opioid use disorder, without addressing the underlying problem.
Recently, medication-assisted therapy with buprenorphine has emerged as a powerful approach to treat opioid use disorder itself. Maximally aggressive care for these patients may require both treating their acute problem (e.g., respiratory failure, sepsis) and also treating their underlying opioid use disorder.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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Medication-assisted therapy is not a new concept in medicine. Methadone has been utilized to treat heroin addiction for decades, but should only be utilized in severe cases. Medication-assisted therapy, utilized by specially-trained physicians treating opioid-addicted patients is ‘relatively new’ in the United States. However, utilizing medications to treat disease has always been an integral part of the practice of medicine.. When utilized appropriately, under the care of a physician and therapist, with participation in counseling and groups, Suboxone has a powerful and lasting effect for people addicted to powerful opiates or opioids. Suboxone is a complex medication, and fortunately now,… Read more »