By vgreene, 4 November, 2019 First assess tx mental illness anxiety depression PTSD If on BZD consider tapering
By vgreene, 4 November, 2019 If also on BZD: Coordinate gradual BZD taper1 to avoid BZD w/d (anxiety, hallucinations, sz, DT, rarely death)
By vgreene, 4 November, 2019 If serious mental illness, high suicide risk/ideation: behavioral health consult before taper
By vgreene, 4 November, 2019 Withdrawal, defined as 1) characteristic opioid withdrawal syndrome, or 2) using opioids/related substance to relieve/avoid w/d sx2
By vgreene, 4 November, 2019 Tolerance, defined as 1) need for markedly increased amounts to achieve intoxication/desired effect, or 2) markedly diminished effect using same amount2
By vgreene, 4 November, 2019 Continued use despite recurrent physical/psych problems caused by substance
By vgreene, 4 November, 2019 Continued use despite recurrent social/interpersonal problems from opioids