Is there evidence of diversion?
- Address safety and misuse
- Assess for elevated suicide risk
- Assess for withdrawal symptoms and offer expedited taper, immediate discontinuation, or medically-assisted withdrawal as indicated
- Continue to monitor for SUD and behavioral health comorbidities and offer treatment as indicate (see VA/DoD SUD CPG and Academic Detailing Tapering Document)
- Consider switch to partial agonist opioids or taper opioids to discontinuation (see Sidebar J)
- Manage with non-opioid modalities (see Sidebar B)
Is there evidence of diversion? - continued
Is there high risk of dangerous behavior (i.e., intentional/self-harm overdose event, accidents, threatening provider)?
- Address safety and misuse
- Assess for elevated suicide risk
- Assess for withdrawal symptoms and offer expedited taper, immediate discontinuation, or medically-assisted withdrawal as indicated
- Continue to monitor for SUD and behavioral health comorbidities and offer treatment as indicate (see VA/DoD SUD CPG and Academic Detailing Tapering Document)
- Consider switch to partial agonist opioids or taper opioids to discontinuation (see Sidebar J)
- Manage with non-opioid modalities (see Sidebar B)
- EXIT ALGORITHM
Is there high risk of dangerous behavior (i.e., intentional/self-harm overdose event, accidents, threatening provider)? - continued
