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Patients with opioid use disorder (OUD) often have undertreated opioid withdrawal, pain and opioid craving while in hospital. Methadone, buprenorphine and slow-release oral morphine are the main opioid agonist treatments (OAT) for OUD in Canada. Short-acting opioids can be used in hospital as OAT adjuncts to relieve patient suffering and enable patients with OUD to receive medically necessary care. Short-acting opioid doses must be tailored to a patient’s opioid tolerance, comorbidities and coprescribed medications. Co-occurring withdrawal syndromes should be evaluated and addressed.