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April 26, 2024

A 35 year old man with opioid use disorder (prescription opioids which progressed to heroin) has initiated office-based treatment

A 35 year old man with opioid use disorder (prescription opioids which progressed to heroin) has initiated office-based treatment with buprenorphine, advanced to 16mg per day. He reports ceasing opioid use, and his urine toxicologies are consistently negative for all opioids but positive for buprenorphine. However, his urines are intermittently positive for benzodiazepines, and he describes drinking alcohol two days per week, sometimes to intoxication. What is the most appropriate next step in his treatment? Question 4 options: Increase buprenorphine to 24mg Refer to methadone maintenance Admit to inpatient detoxification Start an outpatient long-acting benzodiazepine taper Obtain more history

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