Safety and Efficacy of Rapid Methadone Titration for Opioid Use Disorder in an Inpatient Setting: A Retrospective Cohort Study

Original research
by
Klaire, Sukhpreet et al

Release Date

2023

Geography

Canada

Language of Resource

English

Full Text Available

No

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

Inpatient guidelines for methadone titration do not exist, whereas outpatient guidelines lack flexibility and do not consider individual opioid tolerance. The evaluation of rapid, adaptable titration protocols may allow more patient-centered and effective treatment for opioid use disorder in the fentanyl era.

Findings/Key points

In this inpatient cohort, rapid methadone titration was well tolerated and resulted in patients reaching higher doses of methadone than would be possible with a standard schedule, with few adverse events. Given the known effective dose range, this approach may result in shorter time to clinical stabilization and suggests that alternative methadone titration schedules may be safe and effective in appropriately selected patients.

Design/methods

Retrospective chart review (98 patients, 168 visits)

Keywords

Hospitals
Substitution/OAT
Transitions in care/treatment
Clinical guidance
About prescribers
Outcomes