Quick Guide: Acute Pain and Perioperative Management in Opioid Use Disorder The following applies to patients already on a medication for opioid use disorder. Patients who have opioid use disorder but are not on a medication should be managed according the accompanying guidelines “Inpatient Management of Opioid Use Disorder: Buprenorphine” and “Inpatient Management of Opioid Use Disorder: Methadone.” Methadone: Before Surgery - Continue full dose After Surgery - Continue full dose, consider splitting TID Buprenorphine: Before Surgery - Continue full dose - Rarely, decrease to 12 mg 2-3 days prior to surgery After Surgery - Continue full dose, consider splitting TID Naltrexone: Before Surgery - Hold oral for at least 72 hours - Hold IM for at least 30 days After Surgery - Resume when no further need for opioids Support for Hospital Opioid Use Treatment (SHOUT) #Perioperative #Pain #Management #Opioid #UseDisorder #Addiction
