Nonopioid medications for managing opioid withdrawal in acute care settings: A scoping review.
Purpose There are hospitalized patients with chronic opioid use who will experience signs and symptoms of opioid withdrawal who were not on medications for opioid use disorder (OUD) prior to admission, do not want to start or are unable to start medications for OUD during admission, and want to limi...
| Publicado en: | American Journal of Health-System Pharmacy Vol. 82; no. 16; pp. 898 - 906 |
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| Autores principales: | , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187168900&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187168900 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10792082 1X3 jtl: American Journal of Health-System Pharmacy issn: 10792082 maglogo: N pubinfo: dt: Aug2025 vid: 82 iid: 16 pid: 622 pub: Oxford University Press / USA artinfo: ui: 187168900 187168900 187168900 10.1093/ajhp/zxae371 187168900 ppf: 898 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Nonopioid medications for managing opioid withdrawal in acute care settings: A scoping review. aug: au: Erstad, Brian L Quaye, Aurora N Hellwege, Megan E Do, David Kopp, Brian J affil: Department of Pharmacy Practice and Science, University of Arizona R. Ken Coit College of Pharmacy, Tucson, AZ, USA sug: subj: Substance Use Disorders Substance Withdrawal Syndrome Drug Therapy Acute Care Analgesics, Nonnarcotic Therapeutic Use Patient Safety Drug Efficacy Treatment Outcomes Human Scoping Review Inpatients Psychosocial Factors PubMed Embase Cochrane Library Bibliography and References Adrenergic alpha-Antagonists Receptors, Cell Surface Antagonists and Inhibitors GABA Modulators Serotonin Agents Comparative Studies ab: Purpose There are hospitalized patients with chronic opioid use who will experience signs and symptoms of opioid withdrawal who were not on medications for opioid use disorder (OUD) prior to admission, do not want to start or are unable to start medications for OUD during admission, and want to limit or avoid the use of opioids. The purpose of this scoping review was to assess the potential effectiveness and safety of using non-opioid agents for managing acute opioid withdrawal in acute care settings. Methods PubMed (inception to 2024), Embase (inception to 2024), and Cochrane Library (inception to 2024) were the databases evaluated for the literature search. Bibliographies of full-text articles were reviewed for additional relevant papers. Results Twenty-eight studies evaluating nonopioid agents for managing acute opioid withdrawal were identified in the literature search. The agents could be divided into 4 broad mechanistic categories: α-adrenergic receptor agonists, N -methyl- d -aspartate (NMDA) antagonists, gamma-aminobutyric acid (GABA) modulators, and serotonergic agents. Of these drug classes, the available literature suggests the α-adrenergic receptor agonists clonidine and lofexidine have the best evidence of efficacy as alternative agents for acute opioid withdrawal, although the majority of studies comparing such agents to opioids for opioid withdrawal were conducted well before the rise in synthetic opioid overdose deaths and have other methodologic issues that limit firm conclusions concerning efficacy and, particularly, safety. Conclusion For the nonopioid alternative agents that have been studied for acute opioid withdrawal, there is more evidence supporting the efficacy of α-adrenergic receptor agonists as opposed to NMDA antagonists, GABA modulators, or sertonergic agents; however, more research is needed regarding the efficacy and safety of nonopioid alternatives for acute opioid withdrawal in order to better guide clinical decision-making. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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