Management of Opioid Use Disorder in the Hospitalized Adolescent: Tips for the Pediatric Nurse-Q&A from 10-29

Q&A from 10-29

Pdf Summary

The lecture on "Management of Opioid Use Disorder in the Hospitalized Adolescent" provides insights into several key aspects of treating this condition in a clinical setting. <br /><br />1. **COWS Assessment Tool**: The Clinical Opiate Withdrawal Scale (COWS) is essential for evaluating withdrawal symptoms and assessing the need for medication adjustments, particularly buprenorphine dosing. Most adolescents require 16-24 mg of buprenorphine to alleviate withdrawal symptoms. The COWS score, patient drug history, and timing of last use help guide treatment decisions, such as when to safely start buprenorphine without inducing precipitated withdrawal.<br /><br />2. **Sitter Coverage**: For patients with Substance Use Disorder (SUD), especially minors, 1:1 sitter coverage is recommended due to the high flight risk during withdrawal discomfort.<br /><br />3. **Visitation and Phone Restrictions**: Visitor restrictions should limit access to primary caregivers only, excluding friends and significant others. Phone access might be restricted; however, hospital landlines should be accessible for necessary communication with caregivers.<br /><br />4. **Buprenorphine Administration**: Buprenorphine is not limited to abdominal administration; it can be delivered subcutaneously (e.g., Sublocade) or sublingually through various formulations.<br /><br />5. **Information Dissemination**: Efforts are underway to establish a guide for resident physicians, led by Dr. Deepa, to enhance care management.<br /><br />6. **Discharge Resources**: Incorporating resources in the discharge summary is being explored, with considerations to align Pediatric Emergency Department (PED) instructions with inpatient procedures, pending consultations with EPIC leadership.<br /><br />Overall, the lecture emphasizes comprehensive care strategies for adolescents with opioid use disorder, focusing on medication management, safety protocols, and communication pathways, ensuring a structured and supportive treatment environment.

Keywords

Opioid Use Disorder

Hospitalized Adolescent

COWS Assessment Tool

Buprenorphine Dosing

Sitter Coverage

Visitation Restrictions

Phone Access

Subcutaneous Administration

Discharge Resources

Care Management