Advanced Pharmacotherapy in Critical Care Online-A Lot to Gain Without Pain: Guide to Managing OUD in the Intensive Care Unit (Kathryn E. Smith, PharmD, BCCCP, BCPS)

A Lot to Gain Without Pain: Guide to Managing OUD in the Intensive Care Unit (Kathryn E. Smith, PharmD, BCCCP, BCPS)

Video Transcription

Video Summary

The presentation by Catherine Smith at Maine Medical Center discussed Opioid Use Disorder and Opioid Stewardship in the ICU, focusing on managing acute pain in critically ill patients. The speaker shared learning objectives related to pathophysiology, clinical complications, and treatment plans for patients with opioid use disorder. The speaker highlighted the significant increase in opioid-related deaths, particularly due to synthetic opioids, and the rise in ICU admissions for opioid overdose. The discussion also included the DSM-5 criteria for diagnosing opioid use disorder and the importance of increasing knowledge to manage patients with OUD in ICUs. Various medication options for treating OUD were reviewed, such as buprenorphine, methadone, and naltrexone, with considerations for dosing and monitoring in the ICU. The presentation emphasized the importance of continued medications for OUD during critical illness and the management of pain through a multimodal approach involving non-opioid adjuncts. Three patient cases were presented to illustrate the management of acute pain in patients with OUD receiving MOUD or not, including appropriate pain assessment and non-opioid analgesia strategies. The presentation concluded with a summarized approach to managing patients with OUD in the ICU, focusing on verification of dosing, pain assessment, and a comprehensive treatment plan integrating opioids and non-opioid analgesics.

Keywords

Opioid Use Disorder

Opioid Stewardship

ICU

acute pain management

pathophysiology

opioid-related deaths

DSM-5 criteria

medication options

buprenorphine

non-opioid analgesia

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