Long-term Intravenous Heroin Use in Medicine / Internal Medicine — 34yo Man | Psychiatry | SMLE Q#1461
SMLE Question #1461
Medicine / Internal Medicine
Psychiatry
Last updated: February 2026
A 34-year-old man with long-term intravenous heroin use presents to an outpatient addiction clinic 24 hours after his last opioid use. He reports generalized body aches, abdominal cramping, nausea, rhinorrhea, anxiety, and intense cravings. He has attempted to stop opioids several times but relapsed when symptoms became intolerable. He requests a long-term medication to reduce withdrawal symptoms, suppress cravings, and help prevent relapse as he stops opioid use. What is the most appropriate pharmacologic maintenance treatment?
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