Precipitated Withdrawal

An Emergency Medicine Guide to Medication for Opioid Use Disorder


Session originally hosted June 2024. 

When using medication to treat a patient with opioid use disorder (OUD), a common concern is the potential for precipitated withdrawal. However, this potential complication is exceedingly rare when opioid withdrawal is treated appropriately. Conversely, the risks of morbidity and mortality for patients with untreated OUD are very high and far exceed the risk of transient precipitated withdrawal. 

In this training, we will focus on understanding the pharmacology of precipitated withdrawal. Clinical providers will understand the risks associated with methadone and fentanyl use for precipitated withdrawal. By the end of this training, you will gain comfort in the management of precipitated withdrawal in your patients. 

At the conclusion of this training, learners should be able to: 

  • Describe the pharmacology of precipitated withdrawal.   
  • Explain why fentanyl and methadone puts patients at an increased risk for precipitated withdrawal.  
  • Conceptualize how to manage precipitated withdrawal in your patients.  



Note: Continuing medical education (CME) credits are being pursued by the MHA Keystone Center, and we anticipate that these opportunities will count toward the DEA eight-hour training requirement on the treatment and management of patients with opioid or other substance use disorders.

Questions? Feel free to contact

Marissa Natzke