Abstract
BackgroundA common challenge with all opioid use disorder treatment paths is withdrawal management. When withdrawal symptoms are not effectively monitored and managed, they lead to relapse which often leads to deadly overdose. A prerequisite for effective opioid withdrawal management is early identification and assessment of withdrawal symptoms.ObjectiveThe objective of this research was to describe the type and content of opioid withdrawal monitoring methods, including surveys, scales and technology, to identify gaps in research and practice that could inform the design and development of novel withdrawal management technologies.MethodsA scoping review of literature was conducted. PubMed, EMBASE and Google Scholar were searched using a combination of search terms.ResultsWithdrawal scales are the main method of assessing and quantifying opioid withdrawal intensity. The search yielded 18 different opioid withdrawal scales used within the last 80 years. While traditional opioid withdrawal scales for patient monitoring are commonly used, most scales rely heavily on patients’ self-report and frequent observations, and generally suffer from lack of consensus on the criteria used for evaluation, mode of administration, type of reporting (e.g., scales used), frequency of administration, and assessment window.ConclusionsIt is timely to investigate how opioid withdrawal scales can be complemented or replaced with reliable monitoring technologies. Use of noninvasive wearable sensors to continuously monitor physiologic changes associated with opioid withdrawal represents a potential to extend monitoring outside clinical setting.
Highlights
A common challenge with all opioid use disorder treatment paths is withdrawal management
While traditional opioid withdrawal scales for patient monitoring are commonly used, most scales rely heavily on patients’ self-report and frequent observations, and generally suffer from lack of consensus on the criteria used for evaluation, mode of administration, type of reporting, frequency of administration, and assessment window
Use of noninvasive wearable sensors to continuously monitor physiologic changes associated with opioid withdrawal represents a potential to extend monitoring outside clinical setting
Summary
A common challenge with all opioid use disorder treatment paths is withdrawal management. Opioids are natural (e.g., morphine), semi-synthetic (e.g., oxycodone) or synthetic (e.g., tramadol and methadone) narcotics primarily used to treat acute and chronic pain [1]. They are often used recreationally due to their euphoric, tranquilizing, and sedative qualities [2]. Florence et al [8] estimated the total economic burden of prescription opioid overdose, abuse, and dependence for the year 2013 to be $78.5 billion. They found that more than a third of this amount ($28.9 billion) resulted from increased healthcare and substance abuse treatment costs. The opioid crisis is taking a toll on families, especially children, forcing an unprecedented
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