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Comprehensive Assessment

  • Nov 27, 2020
  • 2 min read

Updated: Dec 16, 2020

The American Society of Addiction Medicine Standards describes the value of “comprehensive evaluation.” The “comprehensive assessment” is known as the “a critical aspect of patient engagement and treatment planning’’ and should be conducted during the initial phase of treatment.” The treatment should start with this test. (“ASAM Stand. Care Addict. Spec. Physician,” 2004)


The evaluation of the patient is not essentially the initial visit. The assessment is a critical process and determines the emergency problems. There are concomitant physiological and psychiatric situations which may complicate the treatment of the patient. Due to this reason, the patient needs high attention and care. They have to be transferred to a higher degree of medical history as the regular use of drugs may cause poor treatment results. There are pieces of evidence that show that the use of some drugs during opioid use disorder may result in a poor prognosis. (Author links open overlay panelUdi E.GhitzaDavid H.EpsteinKenzie L.Preston, 2007)(Lions et al., 2014)(Preston et al., 1998)


Medical History


This history should have the following considerations

· The testing for concomitant disease or medical conditions

· Determination of medications

· Identification of allergies

· Identification of pregnancy

· Determination of family medical history

· Determination of the patient’s social history


Special Attention Seekers


Ø Patients with infectious disease history, such as HIV, hepatitis, and TB

Ø Acute trauma patients

Ø Psychiatric patients

Ø Patients with a history of substance use, addiction treatment, or addictive behavior

Ø Patients with a history of pharmacotherapy


Physical Assessment


It is examined by a professional and experienced physician, any other authorized person, or any prescribing physician. All the records should be maintained and recorded before the start of medication for the opioid disorder.


The assessment should comprise of identification of “objective physical signs” of opioid withdrawal or intoxication. Table 1 shows some common signs of withdrawal.

Table 2 shows a list of physical signs of substance (opioid) use disorders. Special care should be made in the identification of IDU by noting the presence of old or new puncture marks. Mostly, injection sites are inside the elbow at the cubital fossa and forearm, but they can be some sites on the extremities.


Evaluation and History taking for Females


The utilization of contraceptive pills and pregnancy are some of the important factors for determining the best treatment. It should be noted that as the treatment becomes effective, the fertility also increases. For the management and treatment of females, sessions with gynecologists are essential.


Lab Tests and Reports


The initial lab testing should include reports of HIV and hepatitis. Mostly, vaccination and serology are advised.

Other tests include:


Ø T.B and Syphilis tests

Ø Complete Blood Count

Ø Liver Function Test


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About Dr. Viveck Baluja and KneeTie Vascular Neurology

Dr. Viveck Baluja, MD, is a board-certified vascular neurologist (American Board of Psychiatry and Neurology — Vascular Neurology) practicing telemedicine across California, Michigan, and Colorado, with additional consultation services available to international families, particularly in India.

KneeTie offers three focused services: emergency stroke second opinions delivered within 24 hours, traumatic brain injury (TBI) consultations for survivors and caregivers, and same-day adult ADHD evaluations for residents of CA, MI, and CO.

Stroke Second Opinion

After a stroke, families often have minutes to make decisions. Dr. Baluja provides a second set of expert eyes from a board-certified vascular neurologist — reviewing imaging, hospital records, and current treatment — typically within 24 hours of request. Common questions include: Was tPA appropriate? Should we pursue thrombectomy? What is the recovery outlook? What rehabilitation makes sense?

TBI Consultation

Traumatic brain injury recovery is rarely linear. Dr. Baluja helps patients and families understand recovery timelines, treatment options, post-concussion syndrome, and red flags that warrant emergency evaluation. Consultations typically last 50 minutes and are scheduled within the same week.

Same-Day Adult ADHD Evaluation

A real evaluation by a board-certified neurologist — not a 7-minute screening. Dr. Baluja's ADHD evaluations include comprehensive history, sleep and lifestyle assessment, and behavioral strategy alongside any medication discussion. Available same-day for residents of California, Michigan, and Colorado.

Why a Vascular Neurologist?

Vascular neurology is a subspecialty focused on stroke, cerebrovascular disease, and brain blood flow — among the rarest neurology subspecialties in the U.S. Most online telehealth services use general practitioners or nurse practitioners. KneeTie is led by a board-certified vascular neurologist with full state licensure and HIPAA-compliant telehealth infrastructure.

Schedule a consultation: Use the booking calendar above to choose a service and reserve a time. For active stroke or post-tPA emergencies, email gorungo@kneetie.com directly with "URGENT" in the subject line.

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