The PMHNP is working at an outpatient substance use facility clinic that provides treatment with buprenorphine. Which of the following is the clinic most likely to use in its policies and procedures prior to the induction of buprenorphine?

Choice A reason: CDT (Carbohydrate-Deficient Transferrin) is a biomarker used to detect chronic alcohol consumption. It is not relevant to opioid withdrawal or buprenorphine induction. Choice B reason: PHQ-9 is a depression screening tool. While useful in behavioral health settings, it does not assess opioid withdrawal symptoms and is not used for buprenorphine induction. Choice C reason: CIWA-AR (Clinical Institute Withdrawal Assessment for Alcohol, Revised) is used to assess alcohol withdrawal severity. It is not appropriate for evaluating opioid withdrawal. Choice D reason: COWS (Clinical Opiate Withdrawal Scale) is the standard tool used to assess the severity of opioid withdrawal. It helps determine the appropriate timing for buprenorphine induction to avoid precipitated withdrawal. It is widely used in substance use treatment protocols.