Background: In 2021 there were over 80,000 opioid overdose deaths. Studies show that inpatient hospitalizations are a vital moment in treating patients with opioid use disorder (OUD). Initiation of opioid agonist therapy (OAT: buprenorphine or methadone) is associated with a profound mortality benefit, with some studies suggesting a number needed to treat of less than [...]

Background: Published work applying game theory to physician-patient interactions is nearly non-existent [1-4]. The most prominent work is the example of an emergency medicine physician being asked to prescribe opiates for a patient they suspect of opiate use disorder (OUD) seeking opiates for secondary gain (McAdams 2014). McAdams’ game theory analysis suggested that institutional pressure [...]

Background: America is facing an opioid epidemic. From 1997 to 2017 there were 702,000 deaths from drug overdoses of which greater than 50% were from opioids. The opioid epidemic knows no boundaries, it affects men and women of all age groups and socioeconomic status. Hospitalists are now seeing more opioid related hospital admissions which have [...]

Background: The incidence of Opioid Use Disorder (OUD) is rising around the world with nearly 27 million people living with OUD globally and over 100,000 opioid overdose deaths each year. The Society of Hospital Medicine recently released a consensus statement for management of patients with OUD admitted to the hospital. This statement included recommendations for [...]

Case Presentation: A 34-year-old male with a history of opioid use disorder (OUD) was admitted after being found down secondary to heroin overdose. He was given 4 mg naloxone in the field with improvement in Glasgow Coma Score from 3 to 12. After naloxone administration, he was tachycardic, tachypneic, hypertensive, and agitated. He reported taking [...]