Concerns of other SUDs- including alcohol, stimulants and sedatives

These  algorithms suggest actions to implement when there are concerns that a patient on chronic opioids may have alcohol, stimulants or sedative use problems.  The algorithms come from a Delphi study in which a panel of experts developed consensus over four rounds of structured discussion.

The algorithms include Recommended actions, which had full consensus of the experts as items to implement, and Not Recommended actions, which had the full consensus of actions NOT to do.  The Consider items could be implemented, depending on the specifics of the situation.  
(Click image to download.)
(Click image to download.)


Merlin JS, Young SR, Starrels JL, Azari S, Edelman EJ, Pomeranz J, Roy P, Saini S, Becker WC, Liebschutz JM. Managing Concerning Behaviors in Patients Prescribed Opioids for Chronic Pain: a Delphi study. J Gen Int Med, 2018 Feb:33(2):166-176.