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The “What I Wish I Knew” series of articles is a service of CPNP’s Resident and New Practitioner Committee. Articles are intended to provide advice from experts for students, residents, and new practitioners. Articles are not intended to provide in-depth disease state or pharmacotherapy information nor replace any peer-reviewed educational materials. We hope you benefit from this “field guide” discussing approaches to unique problems and situations.

Any patient with a medical or psychiatric condition that would warrant medical attention if worsened by withdrawal should be referred for inpatient withdrawal management. If a patient is initially seen in the emergency room, generally a medical workup has been done. This information, along with patient interview, physical assessment and chart review, should be used to rule out conditions such as electrolyte imbalances, liver disease and cardiovascular conditions that can increase the risk of complications.

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