Adding a short-acting opioid such as oxycodone or hydromorphone to medications for opioid use disorder (MOUD) may help prevent patients with opioid withdrawal from discharging themselves from the hospital, according to a
study in
JAMA Network Open.
Why It’s Relevant
Patients with OUD who are experiencing symptoms of withdrawal may be more likely to choose to leave the hospital. To help prevent that, hospital-based clinicians are increasingly using short-acting opioids alongside methadone and buprenorphine to treat withdrawal. While preliminary evidence suggests this is a feasible strategy to manage withdrawal, no published studies have examined whether this practice reduces patient-directed discharge.
By the Numbers
- Researchers examined data from 669 hospitalizations (involving 520 unique patients) at an urban safety-net hospital that had standardized orders for treating opioid withdrawal with short-acting opioids and adjunct medications in addition to MOUD.
- A total of 13.8% hospitalizations ended in an early patient-directed discharge (within the first 72 hours).
- Each doubling of a patient’s daily dose of short-acting opioids was associated with an 8% lower risk of early patient-directed discharge.
- For example, patients receiving 160 morphine milligram equivalents (MMEs) of short-acting opioids (roughly five doses of 20mg oral oxycodone) per day would be 22% less likely to discharge themselves compared with those receiving 20 MMEs per day.
The Other Side
Although there was a dose-dependent association between short-acting opioid dose and early patient-directed discharge, marginal dose increases would probably not affect absolute risk very much. In addition, the researchers didn’t adjust for potential confounders such as physiological dependence or severity of OUD, withdrawal symptoms, or hospital illness.
Takeaway Message
“Our study supports the evolving view that clinicians should incorporate short-acting opioids in addition to MOUD when treating opioid withdrawal among hospitalized patients with OUD, particularly among those with higher opioid tolerance,” the researchers wrote. “Hospitals and addiction consultation teams should invest in educating clinicians to titrate short-acting opioids doses in a safe and effective manner in addition to ensuring access to MOUD.”
Related Information
Source
Alexander Logan, et al. Short-acting opioid dose and patient-directed discharge in hospitalized patients with opioid use disorder. JAMA Network Open. Published online June 16, 2026. doi:10.1001/jamanetworkopen.2026.18698
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