Decision-Making Capacity, Opioid Use Disorder, and the 3-Stage Model of Addiction

Abstract

The assessment of decision-making capacity in hospitalized individuals with acute decompensation of chronic illness is challenging. Such decompensations are often accompanied by pathophysiologic processes that impair cognition and judgment, sometimes subtly. The standard of care has thus evolved such that assessment of decisional capacity is best performed once acute decompensation is stabilized with evidence-based treatment, a process that can take several hours to days.1,2