By vgreene, 22 November, 2016 Assess unstable pt; determine if pt requires in-pt w/d mgmt; treat OUD in light of pt willingness to engage in specialty tx, co-occurring mental health conditions or psychosocial problems;1 offer meds ± psychosocial interventions as indicated; f/u
By vgreene, 22 November, 2016 Do not automatically discharge pts from care who do not respond to tx or who relapse13 [S]
By vgreene, 22 November, 2016 Offer and encourage ongoing systematic relapse prevention efforts or recovery support individualized on basis of tx response [S]
By vgreene, 22 November, 2016 Assess tx response11 periodically and systematically; use standardized, valid instruments12 wherever possible [W]
By vgreene, 22 November, 2016 Psychosocial intervention: If OTP setting, offer individual counseling and/or Contingency Management9 [W]. If office-based tx setting, no specific psychosocial intervention recommended, consider pt preference and provider training/competence [NA]
By vgreene, 22 November, 2016 Pharmacotherapy: Take into account pregnancy-specific factors;3 choose between methadone4 in OTP,5 or buprenorphine alone6-8 in individualized choice of tx setting [S]
By vgreene, 22 November, 2016 Recommend immediate maintenance tx w/ no taper; if pt chooses taper, attempt to minimize w/d sx [N/A]
