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Palliative Care1352 papers

Opioid use disorder

Last edited: 4/23/2026

Overview

Opioid use disorder (OUD) is a chronic condition characterized by compulsive opioid use leading to clinically significant impairment or distress. It encompasses patterns of opioid use that create problems or distress related to their use 110.

Diagnosis

  • Clinical Criteria: Presence of problematic opioid use leading to significant impairment or distress 110.
  • Screening Tools: Use of validated questionnaires like CAGE-AID, though noted to have limitations in identifying nonmedical opioid use 39.
  • Laboratory Tests: Not typically required for diagnosis, but may include toxicology screens to confirm substance use 110.
  • Management

  • First-Line Treatments:
  • - Medication-Assisted Treatment (MAT): Buprenorphine (initial dose varies, typically 4-20 mg sublingual daily) 261118. - Methadone: Used under strict supervision, dose individualized 1718.
  • Adjunctive Treatments:
  • - Counseling and Behavioral Therapies: Cognitive-behavioral therapy, contingency management 110. - Telehealth and Support Programs: Enhanced access to care and support during emergencies 2142. - Pain Management: Multimodal approaches to manage chronic pain without reliance on opioids 51522.

    Special Populations

  • Pregnancy: Balancing pain management and OUD treatment; multidisciplinary care recommended 383031.
  • Pediatrics: Focus on intrauterine exposure and developmental impacts; close monitoring of children born to mothers with OUD 333536.
  • Elderly: Consider age-related changes in pharmacokinetics and pharmacodynamics; cautious opioid prescribing 4529.
  • Comorbidities: Addressing conditions like chronic pain, mood disorders, and polysubstance use concurrently 5566.
  • Key Recommendations

  • Implement Medication-Assisted Treatment (MAT) with buprenorphine or methadone for OUD, tailored to individual needs 21718 (Evidence: Strong).
  • Enhance Prescriber Training to improve attitudes and increase utilization of buprenorphine in emergency settings 21021 (Evidence: Moderate).
  • Utilize Telehealth and Support Programs to maintain continuity of care during public health emergencies 2142 (Evidence: Moderate).
  • Multidisciplinary Care Teams for pregnant women with OUD to address both maternal and fetal health 383031 (Evidence: Moderate).
  • Monitor and Manage Comorbid Conditions such as chronic pain and mental health disorders alongside OUD treatment 5566 (Evidence: Moderate).
  • References

    Showing 100 most recent of 204 indexed papers.

    1 Stilley JAW, Benton M, Douglas AE, Kapp JM. Biosurveillance and the Opioid Crisis in Emergency Medicine: Qualitative Study of Physician Perspectives. JMIR formative research 2026. link 2 Bicket MC, Nguyen T, Dahlem G, Dora-Laskey A, Brummett CM, Gunaseelan V et al.. Association between tailored prescriber training and buprenorphine treatment for opioid use disorder among emergency medicine clinicians. The American journal of emergency medicine 2026. link 3 Koester M, Porto A, Lomotey L, Forray A, Yonkers K, Ashley K. Impact of Project ECHO on Obstetric Providers Caring for Pregnant and Postpartum Individuals With Opioid Use Disorder: A Qualitative Analysis. Journal of addiction medicine 2026. link 4 Beiting KJ, Landi AJ, Pravodelov V, Ari M. An age-friendly opioid use disorder (OUD) care workshop: Applying the 5Ms framework. Gerontology & geriatrics education 2026. link 5 Ellis R, Rodin R. Pain Management in the Older Adult with Opioid Use Disorder. Clinics in geriatric medicine 2026. link 6 Hamm ME, Emerson R, Rogal SS, Bulls HW, Nugent SM, Anderson A et al.. Tailoring of a chronic pain self-management intervention for individuals with opioid use disorder in office-based addiction treatment. Journal of substance use and addiction treatment 2026. link 7 London KS, Deschler E, Butt S, Graver S, Figaniak J, Hersh N et al.. Assessing the Cardiac Safety of a Multimodal Protocol for 'Tranq Dope' Withdrawal: A Retrospective QTc Analysis. The American journal of emergency medicine 2026. link 8 Lim G, Carvalho B, George RB, Bateman BT, Brummett CM, Ip VHY et al.. Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine. Anesthesia and analgesia 2025. link 9 . ACOG Clinical Practice Update: Elimination of the DATA-Waiver Program. Obstetrics and gynecology 2025. link 10 Creighton A, Shecter JD, Kruse M, Wascak K, Murray BP. Effect of opioid use disorder training on the attitudes of emergency medicine providers toward treatment of opioid use disorder. The American journal of emergency medicine 2025. link 11 Torchiano A, Roberts B, Haroz R, Milburn C, Baston K, Heil J et al.. Effects of Emergency Department Training on Buprenorphine Prescribing and Opioid Use Disorder-Associated ED Revisits: Retrospective Cohort Study. The western journal of emergency medicine 2025. link 12 Jones KF, Liou KT, Ashare RL, Worster B, Yeager KA, Merlin J et al.. How Racialized Approaches to Opioid Use Disorder and Opioid Misuse Management Hamper Pharmacoequity for Cancer Pain. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2025. link 13 Lent MR, Dugosh KL, Varsani K, Jonsson A, Kung T, Galluzzi KE. Motivation and experiences of individuals with opioid use disorder and chronic pain using medical cannabis for 12 months. Harm reduction journal 2025. link 14 Kondapaka M, Gupta R, Stevenson MH, Balsara K, Rodrigo ME, Sheikh FH et al.. Post-Operative Pain Control Following LVAD Placement in a Patient with Prior History of Opioid Use Disorder: A Case Report. Journal of pain & palliative care pharmacotherapy 2025. link 15 Morrissey PJ, Quinn M, Mikolasko B, Fadale PD. Optimizing Safe Opioid Prescribing: A Paradigm Shift in Buprenorphine Management for Orthopaedic Surgery. The Journal of arthroplasty 2025. link 16 Obert DP, Park GH, Strong K, Schreier DR, Korn E, Troyas C et al.. Repeated High-dose Fentanyl Administration in Rats Reveals Minimal Tolerance to Unconsciousness, Bradycardia, Muscle Rigidity, and Respiratory Depression. Anesthesiology 2025. link 17 Robinson KM, Eum S, Desta Z, Tyndale RF, Gaedigk A, Crist RC et al.. Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2B6 Genotype and Methadone Therapy. Clinical pharmacology and therapeutics 2024. link 18 Yakovenko I, Mukaneza Y, Germé K, Belliveau J, Fraleigh R, Bach P et al.. Management of opioid use disorder: 2024 update to the national clinical practice guideline. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2024. link 19 Trøstheim M, Eikemo M. Hyperalgesia in Patients With a History of Opioid Use Disorder: A Systematic Review and Meta-Analysis. JAMA psychiatry 2024. link 20 Karavitaki N, Bettinger JJ, Biermasz N, Christ-Crain M, Gadelha MR, Inder WJ et al.. Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement. Endocrine reviews 2024. link 21 Heil JM, Lassiter JM, Salzman MS, Herring A, Hoppe J, Lynch M et al.. A qualitative assessment of emergency physicians' experiences with robust emergency department buprenorphine bridge programs. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2024. link 22 Candelario DM, Dume R, Khan N. Opioid-Associated Emergencies: A Review of Their Management and the Utility of Naloxone. Orthopedic nursing 2024. link 23 Slaunwhite A, Min JE, Palis H, Urbanoski K, Pauly B, Barker B et al.. Effect of Risk Mitigation Guidance opioid and stimulant dispensations on mortality and acute care visits during dual public health emergencies: retrospective cohort study. BMJ (Clinical research ed.) 2024. link 24 Kolla G, Pauly B, Cameron F, Hobbs H, Ranger C, McCall J et al.. "If it wasn't for them, I don't think I would be here": experiences of the first year of a safer supply program during the dual public health emergencies of COVID-19 and the drug toxicity crisis. Harm reduction journal 2024. link 25 South AM, Oller D, Lofwall M, Fanucchi LC. Pain Management in Patients With Opioid Use Disorder on Extended-release Buprenorphine: A Case Report. Journal of addiction medicine 2024. link 26 Carnide N, Feng G, Song C, Demers PA, MacLeod JS, Sritharan J. Occupational patterns of opioid-related harms comparing a cohort of formerly injured workers to the general population in Ontario, Canada. Canadian journal of public health = Revue canadienne de sante publique 2024. link 27 Boden LI, Asfaw A, O'Leary PK, Tripodis Y, Busey A, Applebaum KM et al.. Opioid-related mortality after occupational injury in Washington State: accounting for preinjury opioid use. Occupational and environmental medicine 2024. link 28 El Sherbini A, Liblik K, Lee J, Baranchuk A, Zhang S, El-Diasty M. Opioids-induced inhibition of HERG ion channels and sudden cardiac death, a systematic review of current literature. Trends in cardiovascular medicine 2024. link 29 McNair R, Monaghan M, Montgomery P. Heroin assisted treatment for key health outcomes in people with chronic heroin addictions: A context-focused systematic review. Drug and alcohol dependence 2023. link 30 Turner S, Allen VM, Carson G, Graves L, Tanguay R, Green CR et al.. Guideline No. 443b: Opioid Use Throughout Women's Lifespan: Opioid Use in Pregnancy and Breastfeeding. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2023. link 31 Turner S, Allen VM, Graves L, Tanguay R, Green CR, Cook JL. Guideline No. 443a: Opioid Use Throughout Women's Lifespan: Fertility, Contraception, Chronic Pain, and Menopause. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2023. link 32 Wong W. The fragile state of opioid withdrawal. Science signaling 2023. link 33 Beldick SR, Rohde JF, Short VL, Abatemarco DJ, Goyal NK. Pediatric Primary Care Diagnoses Among Children with Intrauterine Opioid Exposure. Journal of health care for the poor and underserved 2023. link 34 Vella A, Savona-Ventura C, Mahmood T. Harmful effects of opioid use in pregnancy: A scientific review commissioned by the European Board and College of obstetrics and gynaecology (EBCOG). European journal of obstetrics, gynecology, and reproductive biology 2023. link 35 Short VL, Gannon M, Sood E, Harris G, Kale A, Abatemarco DJ et al.. Opportunities to Increase Well-Child Care Engagement for Families Affected by Maternal Opioid Use Disorder: Perceptions of Mothers and Clinicians. Academic pediatrics 2023. link 36 Short VL, Abatemarco DJ, Sood E, Hand DJ, Gannon M, Hossain J et al.. The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children. Trials 2023. link 37 Sedney CL, Dekeseredy P, Singh SA, Holbein M. Stigmatizing Language Expressed Towards Individuals With Current or Previous OUD Who Have Pain and Cancer: A Qualitative Study. Journal of pain and symptom management 2023. link 38 Ellerbroek H, Hanssen I, Lathouwers K, Cillessen L, Dekkers S, Veldman SE et al.. Mindfulness-based cognitive therapy for chronic noncancer pain and prescription opioid use disorder: A qualitative pilot study of its feasibility and the perceived process of change. Brain and behavior 2023. link 39 Amaram-Davila J, Bramati P, Gammon L, Mallipeddi T, Jastrzemski O, Clark MD et al.. Deficiencies with CAGE-AID questionnaire in identifying nonmedical opioid use-a report of two cases. Annals of palliative medicine 2023. link 40 Ferguson M, Medley A, Rittenbach K, Brothers TD, Strike C, Ng J et al.. Priority setting for Canadian Take-Home Naloxone best practice guideline development: an adapted online Delphi method. Harm reduction journal 2022. link 41 . Teletriage in postlockdown practice. The Veterinary record 2022. link 42 Fauteux N. The Growth of Telehealth. The American journal of nursing 2022. link 43 Schoenfeld EM, Soares WE, Schaeffer EM, Gitlin J, Burke K, Westafer LM. "This is part of emergency medicine now": A qualitative assessment of emergency clinicians' facilitators of and barriers to initiating buprenorphine. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2022. link 44 Schneider KE, Rouhani S, Weicker NP, Morris M, Sherman SG. Businesses in high drug use areas as potential sources of naloxone during overdose emergencies. Drug and alcohol dependence 2022. link 45 Downer K, Burgan C, Kezar CE, Galgano SJ. Procedural moderate sedation in patients with opioid addiction and chronic pain: a practical primer for the radiologist. Abdominal radiology (New York) 2022. link 46 Janet Ho J, Jones KF, Sager Z, Neale K, Childers JW, Loggers E et al.. Barriers to Buprenorphine Prescribing for Opioid Use Disorder in Hospice and Palliative Care. Journal of pain and symptom management 2022. link 47 Mohanti BK. Opioid: Plenitude versus pittance. The National medical journal of India 2022. link 48 Spreen LA, Dittmar EN, Quirk KC, Smith MA. Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review. Pharmacotherapy 2022. link 49 Hayes CJ, Goree J, Turpin J, Ortiz H, Smith GR, Gokarakonda SB et al.. Leveraging the Prescription Drug Monitoring Program to Curb Opioid Prescribing in Arkansas. Journal of prevention (2022) 2022. link 50 Ellerbroek H, van den Heuvel SAS, Dahan A, Timmerman H, Kramers C, Schellekens AFA. Buprenorphine/naloxone versus methadone opioid rotation in patients with prescription opioid use disorder and chronic pain: study protocol for a randomized controlled trial. Addiction science & clinical practice 2022. link 51 Lösch L, Brown P, van Hunsel F. Using structural topic modelling to reveal patterns in reports on opioid drugs in a pharmacovigilance database. Pharmacoepidemiology and drug safety 2022. link 52 Etaee F, Tobin M, Vuppala S, Komaki A, Delisle BP, Di Biase L et al.. Effects of opioid receptor agonist and antagonist medications on electrocardiogram changes and presentation of cardiac arrhythmia: review article. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2022. link 53 Gomes T, Kitchen SA, Tailor L, Men S, Murray R, Bayoumi AM et al.. Trends in Hospitalizations for Serious Infections Among People With Opioid Use Disorder in Ontario, Canada. Journal of addiction medicine 2022. link 54 Brogdon H, Facer KL, Cox EJ, Carlson RH, Wurzel JF. Rapid Transition to Buprenorphine in a Patient With Methadone-Related QTc Interval Prolongation. Journal of addiction medicine 2022. link 55 Liu S, Nwabueze C, Pan Y, Walter SM, Su B, Xu C et al.. Polysubstance Use, Mood Disorders, and Chronic Conditions With Anxiety in Opioid Patients. Western journal of nursing research 2022. link 56 . Medication for Adolescents and Young Adults With Opioid Use Disorder. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2021. link 57 Montague E, Bungum M, Sherman L, Gravenor S, Courtney DM, Czerniak A et al.. Using a sociotechnical systems analysis to evaluate an intervention to improve opioid prescribing in emergency medicine. Applied ergonomics 2021. link 58 Harris BR. Suicide as a hidden contributor to the opioid crisis and the role that primary care and emergency medicine play in addressing it. Preventive medicine 2021. link 59 Pourmand A, Beisenova K, Shukur N, Tebo C, Mortimer N, Mazer-Amirshahi M. A practical review of buprenorphine utilization for the emergency physician in the era of decreased prescribing restrictions. The American journal of emergency medicine 2021. link 60 Henderson R, McInnes A, Mackey L, Bruised Head M, Crowshoe L, Hann J et al.. Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies. BMC public health 2021. link 61 Trinh NTH, Singh P, Cerdá M, Bruckner TA. Opioid-related emergencies in New York City after the Great Recession. Journal of substance abuse treatment 2021. link 62 Goodin A, Bae J, Delcher C, Brown J, Roussos-Ross D. Obstetrician-gynecologist perceptions and utilization of prescription drug monitoring programs: A survey study. Medicine 2021. link 63 Shah JR, Ramseyer A, Coker J. Peripartum management for women with opioid dependence. Current opinion in anaesthesiology 2021. link 64 Starr MR, Patel LG, Ammar M, Yonekawa Y. Opioids and ophthalmology: review of the current literature. Current opinion in ophthalmology 2021. link 65 Ramanadhan S, Woodhams E, Srikanth P, White KO. Pain medication requirements in patients with opioid use disorder at the time of surgical abortion: An exploratory study. Contraception 2021. link 66 Chua KP, Brummett CM, Ng S, Bohnert ASB. Association Between Receipt of Overlapping Opioid and Benzodiazepine Prescriptions From Multiple Prescribers and Overdose Risk. JAMA network open 2021. link 67 Flaherty A, Hossain F, Vercelli A. Meeting at the crossroads of pain and addiction: An ethical analysis of pain management with palliative care for individuals with substance use disorders. Journal of opioid management 2021. link 68 Lagisetty P, Garpestad C, Larkin A, Macleod C, Antoku D, Slat S et al.. Identifying individuals with opioid use disorder: Validity of International Classification of Diseases diagnostic codes for opioid use, dependence and abuse. Drug and alcohol dependence 2021. link 69 Kohan L, Potru S, Barreveld AM, Sprintz M, Lane O, Aryal A et al.. Buprenorphine management in the perioperative period: educational review and recommendations from a multisociety expert panel. Regional anesthesia and pain medicine 2021. link 70 Kemény LV, Robinson KC, Hermann AL, Walker DM, Regan S, Yew YW et al.. Vitamin D deficiency exacerbates UV/endorphin and opioid addiction. Science advances 2021. link 71 Malik E, Rozner L, Adelson M, Schreiber S, Peles E. The Relation between Changes in Vitamin D and Vitamin B12 Levels, Body Mass Index and Outcome in Methadone Maintenance Treatment Patients. Journal of psychoactive drugs 2021. link 72 Demir B, Ozsoy F, Buyuk A, Altindag A. ECG changes in patients with opioid use disorder; P-QT wave dispersion: a retrospective study. Journal of addictive diseases 2021. link 73 Price S. Opioids: The Forgotten Epidemic?. Texas medicine 2020. link 74 Hatten BW, Cantrill SV, Dubin JS, Ketcham EM, Runde DP, Wall SP et al.. Clinical Policy: Critical Issues Related to Opioids in Adult Patients Presenting to the Emergency Department. Annals of emergency medicine 2020. link 75 Mastarone GL, Wyse JJ, Wilbur ER, Morasco BJ, Saha S, Carlson KF. Barriers to Utilization of Prescription Drug Monitoring Programs Among Prescribing Physicians and Advanced Practice Registered Nurses at Veterans Health Administration Facilities in Oregon. Pain medicine (Malden, Mass.) 2020. link 76 Foster SD, Lee K, Edwards C, Pelullo AP, Khatri UG, Lowenstein M et al.. Providing Incentive for Emergency Physician X-Waiver Training: An Evaluation of Program Success and Postintervention Buprenorphine Prescribing. Annals of emergency medicine 2020. link 77 Pearce LA, Min JE, Piske M, Zhou H, Homayra F, Slaunwhite A et al.. Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study. 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Prevalence and Geographic Distribution of Obstetrician-Gynecologists Who Treat Medicaid Enrollees and Are Trained to Prescribe Buprenorphine. JAMA network open 2020. link 83 Ardeljan LD, Waldfogel JM, Bicket MC, Hunsberger JB, Vecchione TM, Arwood N et al.. Current state of opioid stewardship. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists 2020. link 84 St Marie B, Broglio K. Managing Pain in the Setting of Opioid Use Disorder. Pain management nursing : official journal of the American Society of Pain Management Nurses 2020. link 85 Herzig SJ, Stefan MS, Pekow PS, Shieh MS, Soares W, Raghunathan K et al.. Risk Factors for Severe Opioid-Related Adverse Events in a National Cohort of Medical Hospitalizations. Journal of general internal medicine 2020. link 86 Panagiotoglou D, McCracken R, Lavergne MR, Strumpf EC, Gomes T, Fischer B et al.. 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The common meanings and shared practices of sedation assessment in the context of managing patients with an opioid: A phenomenological study. Journal of clinical nursing 2019. link 100 Rhee TG, Ross JS, Rosenheck RA, Grau LE, Fiellin DA, Becker WC. Accidental drug overdose deaths in Connecticut, 2012-2018: The rise of polysubstance detection?. Drug and alcohol dependence 2019. link

    Original source

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