Background: In utero opioid exposure can result in neonatal abstinence syndrome (NAS). NAS incidence has increased five-fold in the last decade. NAS is a serious condition characterized by central nervous system hyperirritability and autonomic nervous system and gastrointestinal tract dysfunction. Newborns with NAS may have several potential complications, may require pharmacological management, have increased hospital [...]

Background: Driven by the current opioid epidemic, drug overdose has become the leading cause of unintentional death nationwide. Efforts are underway to decrease unnecessary opioid prescribing. Hospitalists care for many patients with preexisting opioid prescriptions or appropriately prescribed new opioids at discharge. Though naloxone decreases the morbidity and mortality associated with opioid overdose, most patients [...]

Background: Hospitals are compelled by a variety of factors to optimize patient satisfaction. Pain management has been identified as an important determinant of overall inpatient satisfaction. However, effective pain management may be more challenging in the current climate of more cautious opioid use. Purpose: The 32-item Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) [...]

Case Presentation: This is the case of an ex-41 2/7 week baby girl, born to a 28 year old G4P0 now 1 mother via cesarean section for arrest of descent. Early in pregnancy, the mother endorsed occasional marijuana use and had one urine toxicology screen positive for marijuana. Subsequent urine drug screens were all negative, [...]

Case Presentation: Urinary retention affects 4.5% and 0.07% of hospitalized men and women, respectively (Verhamme et al, 2008). The causes vary widely; however, it may occur as a result of opioid use. Opioid-induced urinary retention is under-reported in literature. When opioid induced urinary retention occurs, there is the dilemma of achieving resolution, without reversing pain [...]

Case Presentation: Loperamide is an over-the counter anti-motility opioid agonist considered to be specific to the intestinal µ receptor, safe for non-prescription use, and to have low abuse potential. However, several cases of fatal cardiac arrhythmias have been reported.1 38-year-old male without prior cardiovascular history, presented to a rural hospital with pre-syncope and lightheadedness. He [...]