Background: Naloxone is a medication that reverses opioid overdose in emergency situations and prevents deaths. A group of 55 Eastern Virginia Medical School (EVMS) medical students were trained by REVIVE!, a program that educates on how to recognize and respond to an opioid overdose emergency with the administration of naloxone. We evaluated whether there is [...]

Background: Clinician prescribing practices are a contributing factor to and potential mitigator of the opioid epidemic in the United States. Several studies have identified the hospital setting as an important entry point into chronic opioid use. The Society for Hospital Medicine (SHM) and the Centers for Disease Control and Prevention (CDC) have made recommendations for [...]

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 [...]

Case Presentation: AS is 36-year-old woman with methamphetamine and opioid use disorder (OUD) hospitalized with endocarditis who is evaluated by the Addiction Consult Service (ACS), and started on sublingual Buprenorphine/naloxone (Bup/nx) for treatment of OUD. Urine drug screens continue to be inappropriately positive for methamphetamine inpatient. Extended Release Buprenorphine (Bup-XR) is discussed and with her [...]

Background: To curb the growing opioid epidemic, hospitalists need to re-examine inpatient opioid use and increase utilization of alternatives to opioids for pain management. Of 1.1 million nonsurgical inpatients across 286 US hospitals from July 2009 to June 2010, 51% received an opioid during hospitalization and more than half with inpatient exposure were prescribed opioids [...]