Category: Psychiatric and Social Issues

Opioid Use Disorder – What You Do Matters!

In this long-form episode we will discuss opioid use disorder, the leading cause of death in young adults in the United States. What you do matters!

  1. Why you should care about OUD
  2. What is OUD
  3. Buprenorphine Works


  1. National Safety Counsel Injury Facts
  2. DebunkingDenial – Purdue Pharma and America’s Opioid Epidemic
  3. Addiction Neuroscience 101 – Youtube
  4. Cochran Review – Buprenorphine for OUD

Psychiatric Complaints

The Two Objectives During Every Psychiatric-Type Complaint
  • Medical Clearance
  • Psychiatric Risk Assessment
Medical Clearance
  • Required by EMTALA to perform a “screening exam” regardless of complaint
  • Most psychiatric facilities have poor diagnostic/treatment capabilities for non-psychiatric conditions and will want patient to be “medically cleared”
    • Sometimes they will require specific tests to be performed, blood pressure to be treated, etc
    • My “medical clearance” order set includes
      • Electrolytes
      • CBC
      • Serum Alcohol
      • Urine Drug Screen (UDS)
      • Pregnancy (if appropriate)
      • Tylenol/Salicylate Levels (especially if suicidal)
  • Psychiatric patients frequently have other non-psychiatric emergencies
    • Overdoses (salicylate, acetaminophen, etc)
    • Trauma (alcoholics with subdural hematoma from falls)
    • Encephalopathy (hypoglycemia, encephalitis)
Psychiatric Risk Assessment
  • Will this patient truly put themself or others at risk if sent home due to mental health?
  • Do you need to involuntarily hold patient?
  • Are they having passive thoughts of being dead or true INTENT and PLAN to harm themself?
  • Did they name a specific person/group of people that they intend to harm?
Additional Reading

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