7561E Management of Opioid Use Disorder in the Hospitalized Adolescent: Tips for the Pediatric Nurse-Slides

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The document, "Management of Opioid Use Disorder in the Hospitalized Adolescent: Tips for the Pediatric Nurse" by Deepa Camenga, MD, and Kirsten O’Connor, RN, provides comprehensive guidelines for addressing opioid use disorder (OUD) among hospitalized adolescents. Key points covered in the document include:<br /><br />### Supporting Communities:<br />The SAMHSA-funded Opioid Response Network (ORN) offers resources and technical assistance to address the opioid crisis and stimulant use across states, communities, and organizations.<br /><br />### Opioid Overdose Epidemic:<br />The document highlights the spike in overdose deaths, particularly due to fentanyl, and underscores the need for healthcare providers to be vigilant. It also notes the significant racial disparities in overdose rates, which are higher among AI/AN, Black, Latinx, and White youth.<br /><br />### Clinical Presentation and Assessment:<br />Nurses should be able to recognize clinical signs of OUD, including the use of substances like prescription opioids, heroin, and synthetic opioids like fentanyl. Assessments should include history-taking, physical exams for signs of withdrawal symptoms, and using tools like the Clinical Opioid Withdrawal Scale (COWS).<br /><br />### Medications for OUD:<br />Three primary medications are recommended: buprenorphine (for those 16+), naltrexone (for those 18+), and methadone (for those 18+). Buprenorphine can be administered sublingually or as an injectable, while naltrexone can be given as an extended-release injection. These medications help manage withdrawal symptoms and reduce cravings.<br /><br />### Reducing Stigma:<br />It’s essential to use non-stigmatizing language and adopt a strengths-based approach when interacting with patients. Trauma-Informed Care (TIC) should be applied to avoid re-traumatization and support patient recovery.<br /><br />### Naloxone for Overdose Prevention:<br />All patients should be dispensed naloxone to reverse overdoses, and both patients and caregivers should be trained to use it. Myths about naloxone should be dispelled to encourage its usage.<br /><br />### Confidentiality and Discharge Planning:<br />Adolescent confidentiality laws allow minors to access substance use treatment without parental consent in most states. Discharge planning should ensure that patients leave with necessary medications and support systems in place.<br /><br />### Resources and Support:<br />Various resources for adolescents and their families are listed, including emergency numbers, peer support groups, and treatment locators.<br /><br />The document emphasizes the importance of reducing stigma, understanding the acute and chronic aspects of opioid use, and following protocols for safe and effective treatment to manage OUD in adolescents.

Keywords

Opioid Use Disorder

Hospitalized Adolescents

Pediatric Nurse

Opioid Response Network

Clinical Opioid Withdrawal Scale

Buprenorphine

Naloxone

Trauma-Informed Care

Confidentiality

Discharge Planning