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Opioid withdrawal

Date Last Search Run: Jan 07, 2023
Table last updated: Jan 15, 2023
Data last added: Jan 15, 2023

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)        
2 (fair evidence exists)    
3 (weak evidence exists)      


Interventions

Buprenorphine
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Rate of patient's with opioid use disorder receiving buprenorphine Process ED-MD Melnick ER, Nath B, Dziura JD, Casey MF, Jeffery MM, et al. User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial. BMJ 2022; 377:e069271. Medline
II Supportive (Green) Compliance with treatment Patient ED-MD Krenz JR, Hayes BD, Wakeman SE, Martin A, Raja AS, White BA, Koehl JL. Continuation of outpatient buprenorphine therapy after dispensing Buprenorphine-Naloxone from the emergency department. Clin Toxicol 2022; 60(4):429–32. Medline
III Supportive (Green) Prevention of withdrawal symptoms Patient ED-MD Carroll GG, Wasserman DD, Shah AA, Salzman MS, Baston KE, Rohrbach RA, Jones IL, Haroz R. Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series. Prehosp Emerg Care. 2021 Mar-Apr;25(2):289-293. doi: 10.1080/10903127.2020.1747579. Epub 2020 May 4. PMID: 32208945. Medline
III Supportive (Green) Decrease in symptoms Patient PH-Paramedic & MD Hern HG, Goldstein D, Kalmin M, Kidane S, Shoptaw S, Tzvieli O, Herring AA. Prehospital Initiation of Buprenorphine Treatment for Opioid Use Disorder by Paramedics. Prehosp Emerg Care. 2021 Nov 22:1-7. doi: 10.1080/10903127.2021.1977440. Epub ahead of print. PMID: 34505820. Medline
III Supportive (Green) Program efficacy Patient ED-MD Regan S, Howard S, Powell E, Martin A, Dutta S, Hayes BD, et al. Emergency Department-initiated Buprenorphine and Referral to Follow-up Addiction Care: A Program Description. J Addict Med 2022; 16(2):216–22. Medline
III Supportive (Green) demographic description and patient experience with buprenorphine Patient Other Robbins M, Haroz R, Mazzarelli A, 4th Clements D, Jones CW, Salzman M. Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study. J Subst Abus Treat 2021; 130:108405. Medline


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