British Columbia Centre on Substance Use (BCCSU), Vancouver, BC, V6Z 2A9, Canada (JM, PD, SN); Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada (SN).
J Addict Med. 2021;15(6):519-521. doi: 10.1097/ADM.0000000000000803.
North America's opioid crisis highlights the profound need for low-barrier access to opioid agonist therapy (OAT) for the treatment of opioid use disorder (OUD). This case describes a 33-year-old female with a history of opioid and stimulant use disorder admitted to hospital after a left middle cerebral artery ischemic stroke with resulting aphasia. After medical stabilization, she consented to buprenorphine/naloxone through limited verbal and written communication. After 14 days of titration, she was stabilized on 14 to 3.5 milligrams of buprenorphine/naloxone daily. Buprenorphine/naloxone initiation and titration is patient-based and symptom guided, typically requiring active communication between the patient and care provider. This case illustrates successful buprenorphine/naloxone initiation in a patient with limited receptive and expressive language abilities, emphasizing the feasibility of offering this medication to individuals with limited communication to ensure timely access to evidence-based OUD treatment.
北美阿片类药物危机突出表明，非常需要通过低障碍途径获得阿片类激动剂治疗（OAT），以治疗阿片类药物使用障碍（OUD）。本病例描述了一名 33 岁女性，有阿片类药物和兴奋剂使用障碍史，因左侧大脑中动脉缺血性中风导致言语障碍而住院。在医疗稳定后，她通过有限的口头和书面沟通同意使用丁丙诺啡/纳洛酮。经过 14 天的滴定，她每天稳定在 14 至 3.5 毫克丁丙诺啡/纳洛酮。丁丙诺啡/纳洛酮的起始和滴定是基于患者的情况和症状指导的，通常需要患者和护理提供者之间的积极沟通。本病例说明了在语言接受和表达能力有限的患者中成功起始丁丙诺啡/纳洛酮，强调向沟通能力有限的个人提供这种药物的可行性，以确保及时获得基于证据的 OUD 治疗。
