Methadone Hospital Quick Start - Inpatient Initiation for Opioid Use Disorder and Withdrawal Initial Dosing: - Patients should be dosed according to tolerance. May use morphine equivalent calculator as a guide. Withdrawal severity is not well correlated with tolerance. - Can use adjunctive medications for withdrawal symptoms. - Order naloxone prn sedation/resp depression Complicating Factors: - Allergy to methadone - Respiratory depression - Ramsay sedation scale ?3 - QTc ?500 - Recent use of benzodiazepines, alcohol or other sedatives - Severe liver disease - Medically unstable - If RR <8 or sedated, do not give additional methadone #Methadone #Hospital #Inpatient #Initiation #management #withdrawal #opiate #opioid #algorithm
