Opioid withdrawal syndrome Quiz: Ace Your Exams
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A 34-year-old woman comes to the urgent care clinic for evaluation of anxiety, nausea, and difficulty sleeping. She has been using heroin intravenously for the past two years and has decided to seek help for her addiction. She has been without heroin for 24 hours. Past medical history includes schizophrenia, for which she takes quetiapine. She has no other medical illnesses and does not use other recreational drugs. Temperature is 37.0°C (98.6°F), blood pressure is 130/90 mmHg, heart rate is 98/min, respiratory rate is 18/min, and oxygen saturation is 98% on room air. On examination, she is alert and oriented, her skin is diaphoretic, and pupils are mildly dilated. Neck exam is within normal limits. Cardiopulmonary and abdominal exams are unremarkable except for tachycardia. There are no signs of jaundice. A plan to connect her with the local methadone clinic is underway. Which of the following is the most important test to perform before initiating treatment with methadone?
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