← Chapter 9
Mental Health Nursing · Chapter 9

Pharmacotherapy Bench: The Medication That Fits This Patient

Methadone and buprenorphine each cut all-cause mortality in opioid use disorder by roughly half — which means the wrong medication choice, or a taper demanded to prove commitment, is a mortality decision. In each case below, one detail is the whole answer: a liver, a kidney, a clock, a pregnancy, a pain score. Find it, choose, and then read why every other option fails.
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Your bench so far

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Best action chosen
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Cases decided
The sentence to be able to say out loud. Any programme, unit or family member who insists a person taper off medication for opioid use disorder to prove their commitment is asking them to accept a higher chance of dying. Say it clearly and say it kindly.
Pain management on this medication is a nursing competency. Buprenorphine and methadone doses treat the use disorder, not acute pain. Withholding analgesia to avoid “feeding the addiction” is not caution — it is under-treatment, it is a documented health disparity, and untreated pain is itself a potent trigger for a return to use.

Monitoring and teaching — open any drug

And the gap worth knowing. There are no approved medications for stimulant or cannabis use disorder. Contingency management — structured tangible reinforcement for verified negative toxicology — has the strongest evidence for stimulants, and it is a psychosocial intervention nurses can actively support.