13
Figure 2. Pregnancy
History
• Concomitant medical conditions
(hepatitis, HIV, TB, acute trauma)
• Other substance use including
tobacco
Psychosocial assessment
Laboratory
• CBC, LFTs,
• Hepatitis A, B & C
• HIV, STDs
• Urine drug testing
Social and
Environmental Factors
Identify and refer urgent problems
Encourage breastfeeding
• Hepatitis A & B vaccines (if seronegative)
• HIV counseling
• Psychosocial treatment
Naltrexone
• Should not be initiated
• May be discontinued if
risk of relapse is low
• Continue only with
consent
LEGEND
Diagnosis/Evaluation
Treatment
Results, Notes, Status
Important Comments
Methadone
• Start early
• Consider Level 4 to
initiate
• Dose increases may
be needed
Buprenorphine
(monoproduct)
• Consider Level 4 to
initiate treatment
(especially in 3rd
trimester)
