|
Suboxone therapy
|
UA results
|
|
cravings
|
Side effects
|
|
anxiety
|
at risk behavior/chance of diversion
|
|
feeling down, depressed, suicidal thoughts
|
additional medications for symptoms
|
|
tremors, sweating, nausea, diarrhea
|
Hallucinations, visual, audible
|
|
difficulty sleeping
|
feeling down, depressed, thoughts of suicide
|
|
Illegal Drug Use?
|
outside program, CBT, names or # needed
|
|
TOTAL, 5 QUESTIONS
|
Suboxone Dose continued
|
|
|
|
|
Suicidal Urges
|
|
|
Do you have any suicidal thoughts?
|
|
|
Would you like to end your life?
|
|
|
TOTAL, 2 QUESTIONS
|
|
|
|
|
|
Anxiety
|
|
|
Anxious or nervous
|
|
|
Worrying about things
|
|
|
Trouble relaxing
|
|
|
Easily annoyed or irritable
|
|
|
Feeling afraid/something awful may happen
|
|
|
TOTAL, 5 QUESTIONS
|
|
