As the patients approach 48-72 hours near the end of the need for continuous infusion or opioid, per decision by the medical staff, they will be weaned from infusions. The Naloxone infusion will remain unchanged. The Naloxone infusion or normal saline infusion will be discontinued when the Fentanyl infusion is discontinued. The Fentanyl infusions will be decreased by 25% of original dose every 12 hours until off. Once patients start the Fentanyl wean they will have withdrawal assessed every six hours and as needed using the Modified Narcotic Withdrawal Scale (MNAS, see appendix 2). Patients receiving two successive scores of 8 or above will be determined to have withdrawal. These patients will be started on Methadone as directed by the primary team and Fentanyl infusion will continue to be decreased by 25% every 12 hours until off. As patients are weaned from continuous infusions they will continue to have assessments every 6 hours using MNAS until infusions are discontinued. Once the continuous infusion of Fentanyl is discontinued the patient information will continue to be monitored using MNAS and vital signs stated earlier for 4 days or until ICU discharge.