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Ethical Considerations in Use of Injectable Opioid Agonist Treatment in Pregnancy

Ethical Considerations in Use of Injectable Opioid Agonist Treatment in Pregnancy COMMENTARY Ethical Considerations in Use of Injectable Opioid Agonist Treatment in Pregnancy Michael Weaver, MD, DFASAM The patient provided verbal informed consent on sev- (J Addict Med 2021;15: 357–358) eral occasions to receive the highly individualized iOAT regimen with high doses of multiple opioids, and articulated his case commentary involves a patient in her third that her care was outside the standard for OUD in pregnancy. T trimester of pregnancy who was admitted to a monitored Informed consent is a legal and ethical duty in medical inpatient setting for treatment of opioid use disorder with treatment, and is a critical component of autonomy. Compe- high-dose injectable opioid agonist therapy (iOAT) using tence or capacity is defined as the ability to understand, hydromorphone after she had recurrent overdoses due to deliberate, make rational choices, and communicate one’s continued illicit fentanyl use at a viable gestational age despite choice. The capacity of the case patient to provide truly high-dose methadone combined with slow-release oral mor- informed consent may have been compromised by intoxica- phine. The use of this enhanced treatment plan with multiple tion with potent intravenous opioids—either illicit fentanyl or opioid agonists helped the patient to abstain from illicit opioid http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Addiction Medicine Wolters Kluwer Health

Ethical Considerations in Use of Injectable Opioid Agonist Treatment in Pregnancy

Weaver, Michael
Journal of Addiction Medicine , Volume 15 (5) – Sep 10, 2021
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References (10)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2020 American Society of Addiction Medicine
ISSN
1932-0620
eISSN
1935-3227
DOI
10.1097/adm.0000000000000777
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY Ethical Considerations in Use of Injectable Opioid Agonist Treatment in Pregnancy Michael Weaver, MD, DFASAM The patient provided verbal informed consent on sev- (J Addict Med 2021;15: 357–358) eral occasions to receive the highly individualized iOAT regimen with high doses of multiple opioids, and articulated his case commentary involves a patient in her third that her care was outside the standard for OUD in pregnancy. T trimester of pregnancy who was admitted to a monitored Informed consent is a legal and ethical duty in medical inpatient setting for treatment of opioid use disorder with treatment, and is a critical component of autonomy. Compe- high-dose injectable opioid agonist therapy (iOAT) using tence or capacity is defined as the ability to understand, hydromorphone after she had recurrent overdoses due to deliberate, make rational choices, and communicate one’s continued illicit fentanyl use at a viable gestational age despite choice. The capacity of the case patient to provide truly high-dose methadone combined with slow-release oral mor- informed consent may have been compromised by intoxica- phine. The use of this enhanced treatment plan with multiple tion with potent intravenous opioids—either illicit fentanyl or opioid agonists helped the patient to abstain from illicit opioid

Journal

Journal of Addiction Medicine – Wolters Kluwer Health

Published: Sep 10, 2021

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