Monitoring
Opioid use disorder is a chronic, relapsing disease that requires long-term monitoring. Periodic urine drug screens during treatment are helpful for assessing compliance and abstinence not only from opioids but also from other potential drugs of abuse.[191]
Other laboratory tests that may be indicated during follow-up include electrolytes, complete blood count, blood urea nitrogen/creatinine, liver function tests (LFTs), rapid plasma reagin, hepatitis serologies, HIV testing, tuberculosis testing, and blood cultures. Due to risk of malnutrition, it is helpful to assess hematologic function and electrolytes. LFTs and renal function are important for assessing whether medication dosing adjustments are required. Infectious labs are important due to high risk of exposure from intravenous drug users and/or high-risk behaviors while using drugs. Beta human chorionic gonadotropin (beta-hCG) may be done if pregnancy is suspected during course of treatment.
Continued assessment of patient motivation for change and evidence of family and social support is important.
The Addiction Severity Index (ASI) is a widely known and widely used structured interview designed to assess the client's problem severity in seven areas of functioning: medical status, employment/support status, drug use, alcohol use, legal status, family/social relationships, and psychiatric status. The ASI is useful for follow-up because a comparison of ASI scores at baseline and follow-up can provide an objective and standardized measure of improvement. Addiction Severity Index Opens in new window
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