Inpatient Management of Opioid Use Disorder: Methadone vs Buprenorphine - Comparison Table



Some patients may decline buprenorphine or methadone, but still be interested in medication assisted treatment. In these cases, one option is naltrexone, however it has been shown to have very high drop-out rates so is not considered first line . Naltrexone can only be started after a patient has completely withdrawn from opioids—roughly 5-7 day for short acting and 7-10 days for long acting. One option is to give naloxone as a trial before administering naltrexone, to make sure the patient doesn’t experience precipitated withdrawal. Dosing usually begins with 25mg on the first day, and is then increased to 50 mg daily. For IM formulation, the dose is usually 380 mg q4 weeks. The most common side effects are nausea, vomiting,

and headache.



Support for Hospital Opioid Use Treatment (SHOUT)



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