UM Guidelines
Substance-Related Disorders: Inpatient Care

Behavioral Health (BH)

BCBST last reviewed September 20, 2017*

Revised both Adult and Child/Adolescent opioid withdrawal criteria:
  • Severely complicated opioid withdrawal that requires around-the-clock care is present as manifested by 1 or more of the following:
    • Vomiting or diarrhea due to opioid withdrawal leading to marked dehydration or electrolyte abnormality that cannot be corrected (to near normal) in emergency department or other ambulatory setting (e.g., serum potassium less than 2.5 mEq/L (mmol/L), serum sodium less than 130 mEq/L (mmol/L)
    • Pregnancy
    • Immunocompromised condition or significant medical co-morbidity
    • Significant concurrent use of other drug classes


  1. Electronic Code of Federal Regulations:  §8.12   Federal opioid treatment standards, Title 42: Public Health, PART 8—CERTIFICATION OF OPIOID TREATMENT PROGRAMS Subpart B—Certification and Treatment Standards.  Retrieved 9/16/15 from http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=858aacf1e64a476824d5e53dbec44913&ty=HTML&h=L&mc=true&r=SECTION&n=se42.1.8_112.
  2. Opioid Abuse Treatment & Management, Preda, Adrian, Dunayevich, Eduardo, and Liskow, Barry I. Retrieved 9/16/15 from http://emedicine.medscape.com/article/287790-treatment.
  3. Hypokalemia, Lederer, Eleanor, Batuman, Vecihi, Nayak, Vibha, Alsauskas, Zygimantas C, and Mackelaite Lina.  Retrieved on 9/15/16 from http://emedicine.medscape.com/article/242008-overview.



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