title: Managing Opioid Use Disorder During and After Acute Hospitalization: A Case-Based Review Clarifying Methadone Regulation for Acute Care Settings.
abstract: OBJECTIVE
  Treatment with an opioid agonist such as methadone or buprenorphine is the standard of care for opioid use disorder. Persons with opioid use disorder are frequently hospitalized, and may be undertreated due to provider misinformation regarding the legality of prescribing methadone for inpatients. Using a case-based review, this article aims to describe effective management of active opioid withdrawal and ongoing opioid use disorder using methadone or buprenorphine among acutely ill, hospitalized patients.
  
  
  METHODS
  We reviewed pertinent medical and legal literature and consulted with national legal experts regarding methadone for opioid withdrawal and opioid maintenance therapy in hospitalized, general medical and surgical patients, and describe a real-life example of successful implementation of inpatient methadone for these purposes.
  
  
  RESULTS
  Patients with opioid use disorders can be effectively and legally initiated on methadone maintenance therapy or buprenorphine during an inpatient hospitalization by clinical providers and successfully transitioned to an outpatient methadone maintenance or buprenorphine clinic after discharge for ongoing treatment.
  
  
  CONCLUSIONS
  Inpatient methadone or buprenorphine prescribing is safe and evidence-based, and can be used to effectively treat opioid withdrawal and also serves as a bridge to outpatient treatment of opioid use disorders.
authors.affiliation: Brown University and Warren Alpert Medical School, Providence, RI, USA ; Lifespan Corporation, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Noska
authors.affiliation: Brown University and Warren Alpert Medical School, Providence, RI, USA.
authors.forename: Aron
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Massachusetts General Hospital, Department of Medicine, Boston, MA, USA ; Harvard Medical School, Boston, MA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wakeman
authors.affiliation: Brown University and Warren Alpert Medical School, Providence, RI, USA ; Lifespan Corporation, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA.
authors.forename: Josiah
authors.initials: J
authors.lastname: Rich
authors.affiliation: Massachusetts General Hospital, Department of Medicine, Boston, MA, USA ; Harvard Medical School, Boston, MA, USA ; Collaborative Healthcare Strategies, Lexington, MA, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Boutwell