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In every casehealthcare providers should always be prepared to manage withdrawal symptomatically with non-opioid medications because there is no completely reliable method for determining whether a patient has had an adequate opioid-free periodA naloxone challenge test may be helpfulhowevera few case reports have indicated that patients may experience precipitated withdrawal despite having a negative urine toxicology screen or tolerating a naloxone challenge testusually in the setting of transitioning from buprenorphine treatmentPatients should be made aware of the risks associated with precipitated withdrawal and encouraged to give an accurate account of last opioid usePatients treated for alcohol dependence with REVIA should also be assessed for underlying opioid dependence and for any recent use of opioids prior to initiation of treatment with REVIAPrecipitated opioid withdrawal has been observed in alcohol-dependent patients in circumstances where the prescriber had been unaware of the additional use of opioids or co-dependence on opioids.
REVIA should be considered as only one of many factors determining the success of treatmentTo achieve the best possible treatment outcomeappropriate compliance-enhancing techniques should be implemented for all components of the treatment programincluding medication compliance.
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