Hospital-Based Management of Opioid Use Disorder in the Fentanyl Era—The Role and Limits of Expert Consensus

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Illicitly manufactured fentanyl is the leading cause of opioid-involved overdose deaths in the US, complicating treatment for opioid use disorder (OUD).
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Expert consensus supports modifying existing protocols for initiating medications for opioid use disorder (MOUD) in hospitalized patients, especially for heavy fentanyl users.
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Hospitalized patients with OUD often present with complex medical issues, necessitating individualized treatment approaches rather than strict adherence to protocols.
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Monitoring emerging drug contaminants and local prevalence is essential for adapting clinical practices and ensuring effective treatment for OUD in hospitals.
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Successful MOUD initiation in hospitals requires effective discharge planning and linkage to ongoing treatment to sustain recovery and reduce mortality.

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