Suspected Substance Withdrawal in Adolescents Clinical Pathway — Inpatient
Suspected Substance Withdrawal in Adolescents Clinical Pathway — Inpatient
Discharge Planning
- Discharge planning begins day of admission via Social Work Consult and Case Management
- Planning continues during withdrawal screening wait periods
- Ensure bridge to outpatient follow-up
- Address withdrawal from all substances (nicotine, cannabis, etc.) before discharge
Consider Family Meeting
- Interdisciplinary with primary team, Behavioral Health, Social Work
- Coordinated by the unit-based social worker
- Occurs before discharge
Opioids
If CHOP Retail Pharmacy does not have product, physicians may consider sending discharge prescriptions to the outpatient HUP pharmacy
Bridge to Outpatient Treatment
- E-prescribe buprenorphine/naloxone sufficient until follow-up appointment
- Adolescent should have prescription in their possession prior to discharge
- Dispense naloxone from the free supply if available (Naloxone Resources Patient Instructions);
if unavailable, e-prescribe intranasal naloxone at discharge - Instruct adolescent to return to ED if withdrawal recurs before follow-up