Overview

Your patient is in opioid withdrawal, hasn't told you about the fentanyl, and the COWS score is climbing while you decide whether to start buprenorphine today or refer to a program with a six-week waitlist. That hesitation - that gap between knowing addiction is a medical disorder and knowing exactly what to do about it - costs lives every single day in every clinical setting in America. This handbook closes that gap, giving every prescriber the pharmacological precision, clinical decision frameworks, and evidence base to treat substance use disorders with the same confidence they bring to managing hypertension or heart failure. INSIDE THIS BOOK: - The Bernese low-dose induction protocol - initiate buprenorphine in fentanyl-dependent patients without precipitated withdrawal, eliminating the barrier that turns away the patients who need MOUD most - CIWA-Ar to delirium tremens - a step-by-step alcohol withdrawal protocol that tells you exactly when to escalate, what dose ceiling to ignore, and why phenytoin has no role here - Substance-by-substance clinical mastery - from ketamine cystopathy to toluene leukoencephalopathy to GHB withdrawal, the presentations that kill patients when clinicians don't recognize them - Integrated dual-diagnosis treatment - why sequential care fails, and how to treat depression, PTSD, and bipolar disorder simultaneously with SUD from the first visit - Post-incarceration overdose prevention - the data that make the case for correctional MOUD, and the clinical protocol that reduces post-release overdose mortality by 60 percent - Harm reduction as medicine - naloxone prescribing, fentanyl test strips, syringe service programs, and the evidence that saves lives before patients are ready for treatment Written for physicians, nurse practitioners, physician assistants, pharmacists, residents, and any clinician who encounters substance use disorders - which is every clinician. Add this to your clinical library and treat every patient with substance use disorder the way the evidence has always said they deserve.

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