Managing Iatrogenic Opioid Dependence with Methadone
As advances in critical care medicine have made possible the management of more severely ill children, the need for long-term sedation and analgesia has increased. In many of these patients, prolonged administration of opioids is necessary to provide comfort, but may result in the development of tolerance and physiologic dependence. After dependence has developed, abrupt discontinuation will produce symptoms of withdrawal. To avoid withdrawal, opioid exposure must be slowly decreased to allow for physiologic readjustment.