Opioid Abuse Guidelines

Updated: Mar 23, 2020
  • Author: David W Dixon, DO; Chief Editor: Glen L Xiong, MD  more...
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Guidelines

Guidelines Summary

Substance Abuse and Mental Health Services Administration

In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) released considerations for the care and treatment of mental and substance use disorders in the COVID-19 pandemic. [80, 81, 82]

SAMHSA advises that outpatient treatment options be used to the greatest extent possible. Inpatient facilities should be reserved for those for whom outpatient measures are not considered an adequate clinical option. SAMHSA strongly recommends the use of telehealth and/or telephonic services to provide evaluation and treatment of patients.

States may request blanket exceptions for all stable patients in an opioid treatment program (OTP) to receive 28 days of Take-Home doses of the patient’s medication for opioid use disorder (OUD). States may request up to 14 days of Take-Home medication for those patients who are less stable but who the OTP believes can safely handle this level of Take-Home medication.

American Society of Addiction Medicine

In response to the COVID-19 pandemic, the American Society of Addiction Medicine (ASAM) released a focused update to its National Practice Guideline for the Treatment of Opioid Use Disorder (NPG). [83]  New recommendations include the following:

  • Comprehensive assessment of a patient is critical for treatment planning, but completing all assessments should not delay or preclude initiating pharmacotherapy for opioid use disorder (OUD)

  • If patients can't access psychosocial treatment because they are in isolation or have other risk factors that preclude external interactions, clinicians should not delay initiation of medication for the treatment of addiction

  • Home-based buprenorphine induction is safe and effective for treatment of OUD