Challenges of Methadone Dosing in Opioid Use Disorder

The chapter explores the complexities of methadone dosing in a 25-year-old woman with severe opioid use disorder hospitalized with an epidural abscess, emphasizing the importance of careful monitoring and dose adjustments in high fentanyl exposure cases. It discusses the treatment strategy involving methadone dose adjustments, oxycodone for pain management, and the use of supportive medications while highlighting the need for vigilant monitoring and supportive care during hospitalization. The chapter also covers the titration schedule for methadone in treating opioid use disorder, detailing a gradual dosing regimen over several days and the risks associated with rapid dose escalations.