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Patients with opioid use disorder (OUD) frequently present to the emergency department for acute treatment of overdose and withdrawal. A 29-year-old male presented to the emergency room after intravenous heroin use followed by accidental ingestion of naltrexone. He was treated with buprenorphine with significant improvement in his Clinical Opioid Withdrawal Score, from moderately severe to mild withdrawal symptoms within a few hours. Buprenorphine and minimal supportive care can be used to treat acute withdrawal precipitated by oral nalt

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