Medication Schedule for Substance Use Disorder Treatment

Daily Tracking and Management Guide

Psychiatry

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Last updated: Mar 24, 2025

Patient Information

Name: _________________________ Date: __________________________

Daily Medication Schedule

Morning Medications (6:00 AM - 9:00 AM)

  • Medication 1: _________________ Dose: _____ Time: _____
  • Medication 2: _________________ Dose: _____ Time: _____

Afternoon Medications (12:00 PM - 3:00 PM)

  • Medication 1: _________________ Dose: _____ Time: _____
  • Medication 2: _________________ Dose: _____ Time: _____

Evening Medications (6:00 PM - 9:00 PM)

  • Medication 1: _________________ Dose: _____ Time: _____
  • Medication 2: _________________ Dose: _____ Time: _____

Important Guidelines

Medication Safety

  • Take medications exactly as prescribed
  • Do not skip doses or adjust dosage without consulting your healthcare provider
  • Store medications in a secure, dry place away from children
  • Do not share medications with others

Emergency Contacts

Prescribing Provider: _____________________ Phone: _________________________________ Emergency Services: 911 Poison Control: 1-800-222-1222

Weekly Progress Tracking

Week of: ________________

Day Medications Taken Side Effects Cravings (1-10)
Mon
Tue
Wed
Thu
Fri
Sat
Sun

_Patient Signature: _____________________ Date: _____________________ Provider Signature: _____________________ Date: _____________________

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