By vgreene, 24 October, 2017 Start recommended opioid-antagonist maintenance regimen: injectable extended-release naltrexone4,5 [S]
By vgreene, 24 October, 2017 If w/d sx: ✓indications for in-pt tx: unstable medical/mental health condition, incl suicide/OD risk; co-occurring alcohol/sedative-hypnotic use disorder. Take into account pregnancy-specific factors.2 Tx w/d sx w/ maintenance agonist tx, as psycho
By vgreene, 24 October, 2017 Assess: hx, PE, mental status exam, med hx (incl OTC), lab tests as indicated, COWS for severity of w/d sx
By vgreene, 24 October, 2017 Prefers injectable ER naltrexone office based tx when opioid agonist contraindicated or unavailable or unacceptable
By vgreene, 24 October, 2017 Assess pt stability need for in pt w d tx tx any w d sx discuss risks benefits of buprenorphine or methadone and lesser known risks benefits of injectable naltrexone in pregnancy initiate maintenance tx use addiction focused medical mgmt offer psychosocia
By vgreene, 23 October, 2017 Prefers to attend licensed, certified Opioid Treatment Program (OTP, eg, methadone clinic) for buprenorphine (alone) or methadone tx
By vgreene, 23 October, 2017 Assess pt stability and need for in-pt w/d tx; tx w/d sx as needed; refer to OTP1 for maintenance tx; educate pt; offer psychosocial intervention2
By vgreene, 23 October, 2017 Offer optional psychosocial intervention: individual counseling and/or contingency mgmt,10 considering pt preferences and provider training/competence [W]
By vgreene, 23 October, 2017 Educate on risks of untreated opioid use disorder (OUD), incl fetal/maternal OD death
