Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: Despite a public health crisis – over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. Medication-Assisted Treatment (MAT), such as with buprenorphine, is associated with significantly higher rates of abstinence and follow-up, lower rates of [...]

Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: Despite a public health crisis – over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. Medication-Assisted Treatment (MAT), such as with buprenorphine, is associated with significantly higher rates of abstinence and follow-up, lower rates of [...]

Background: The volume of opioid prescriptions in the US has increased dramatically over the last two decades, and strong evidence suggests that this has perpetuated opioid misuse, addiction, overdose, and drug-related deaths. We aimed to learn if there are differences in opioid prescribing among generalist physicians, NPs, and PAs to Medicare beneficiaries. Methods: We performed [...]

Background: While prescription opioids have a role in treating certain pain conditions, their injudicious use has led to an epidemic with myriad adverse outcomes. We sought to evaluate the association of socioeconomic and racial disparities with healthcare utilization and outcomes in opioid overdose related hospitalizations using National Inpatient Sample (NIS) database from 2012 through 2014. [...]

Background: It is often challenging to assess pain in patients on chronic opioids either in acute care setting or in outpatient centers. Pain assessment in this group is more challenging especially if they are hospitalized with acute or acute on chronic pain. Opioid uses associated with increased pain perception and increased self-report of pain. Further, [...]

Background: The number of drug overdose deaths in the United States has never been higher and over 75% of these deaths involved opioids. Hospitalists contribute to opioid initiation for millions of patients a year and, just last year, Internal Medicine (IM) residents at our institution prescribed 479 new opioid prescriptions to patients discharging from the [...]

Background: Hospital inpatients frequently require opioid analgesics for pain management, with more than half of US patients in acute-care facilities receiving opioids during their stay. With the rise of opioid drug therapy, the need to identify inpatient prescription patterns has become urgent, given that mortality rates attributed to prescription opioids have more than tripled since [...]

Background: Persons with opioid use disorder (OUD) represent an estimated 4-11% of hospitalized patients and are increasingly admitted for opioid-related complications. In response to the opioid epidemic, national organizations have recommended hospitals develop protocols to engage patients with OUD in opioid agonist treatment (OAT) during hospitalization. Buprenorphine is an effective OAT for OUD that is [...]