Advanced Inpatient Management of Opioid Use Disorder in a Patient Requiring Serial Surgeries

Opioid use disorder has affected many lives across the US. Medications for opioid use disorder (MOUD), including buprenorphine, have been shown to decrease mortality in this patient population. Here we present a case of a 32-year-old woman on buprenorphine/naloxone undergoing multiple surgical operations, whose course included buprenorphine discontinuation, methadone initiation, and buprenorphine re-induction using a novel microdosing approach. This report includes a presentation of the case and a discussion of the clinical decision making and relevant literature to give hospital-based providers a perspective on management of peri-operative patients on MOUD. (C) Society of General Internal Medicine 2021

Automated summary

Opioid use disorder has impacted many lives in the US, with medications like buprenorphine shown to decrease mortality in patients. This case study of a 32-year-old woman undergoing multiple surgeries highlights the use of buprenorphine/naloxone, methadone, and a novel microdosing approach. The report aims to provide hospital-based providers with insights on managing peri-operative patients on medications for opioid use disorder.