A 32-year-old with opioid use disorder presents to the ED 24 hours after last fentanyl use with COWS 13 (moderate withdrawal). He is interested in tre...

Question

A 32-year-old with opioid use disorder presents to the ED 24 hours after last fentanyl use with COWS 13 (moderate withdrawal). He is interested in treatment. Which initiation strategy is appropriate?

Accepted Answer

Initiate buprenorphine-naloxone 8 mg sublingual now, monitor, and titrate based on withdrawal.

Answer

Administer methadone 80 mg now and discharge.

Answer

Delay medication until COWS >=20 to avoid precipitated withdrawal.

Answer

Start naltrexone 50 mg orally now.

Answer

Give buprenorphine 2 mg sublingual and reassess in 48 hours.

us-abem MCQ (SBA): Opioid Use Disorder

A 32-year-old with opioid use disorder presents to the ED 24 hours after last fentanyl use with COWS 13 (moderate withdrawal). He is interested in treatment. Which initiation strategy is appropriate?