12
Treatment
Figure 1. Evaluation and Treatment
Physical
History
• Concomitant medical conditions
(hepatitis, HIV, TB, acute trauma,
pregnancy)
• Other substance use including
tobacco
• Offer hepatitis B vaccine (?)
• Offer contraception (?)
• Withdrawal management (WM)
Mental Health Status
• (See Co-Occurring
Psychiatric Disorders)
Laboratory
• CBC, LFTs, HIV,
hepatitis A, B & C
• Urine drug testing (frequently)
• STDs(?)
• Pregnancy(?)
Social and
Environmental Factors
Relapse prevention Switch medications
Psychosocial treatment
Pain
(See Individuals with Pain)
Buprenorphine
a
Methadone Naltrexone
Level 1
Outpatient,
general medical or
addiction /WM
Level 2
Specialty
addiction intensive
outpatient /WM
Level 3
Residential
/WM
Level 4
Hospital
/WM
Select treatment site
Identify and refer urgent problems
Relapse
Procedure
1. Change in
treatment
plan– focus
on medication
adherence
2. Consideration
of intensity of
care
3. Switch
medications
a
Use combination product unless otherwise specified.
• Clonidine • Other ancillary medications
To address withdrawal symptoms, add:
LEGEND
Diagnosis/Evaluation
Treatment
Results, Notes, Status
Important Comments
