Managing an Opioid-Dependent Patient, Including Acute Opioid Toxicity

The growing prevalence of opioid use disorder (OUD) within the general population increases the likelihood of patients impacted by OUD being admitted to the intensive care units. Such patients could require intensive care management for the signs and symptoms of acute opioid toxicity or, more likely, require ICU admission for other medical conditions but have a coincident diagnosis of OUD. The management of opioid-tolerant patients in the intensive care unit (ICU) poses significant challenges for the team as they try to balance the risk of untreated pain with opioid overdose. This chapter discusses the management of patients impacted by acute opioid toxicity, while also providing guidance on the management of an opioid-tolerant patient in the ICU.