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JAMA Clinical Guidelines Synopsis |

Clinical Management of Opioid Use Disorder

Beth Dunlap, MD1; Adam S. Cifu, MD2
[+] Author Affiliations
1Northwestern University, Chicago, Illinois
2University of Chicago, Chicago, Illinois
JAMA. 2016;316(3):338-339. doi:10.1001/jama.2016.9795.
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This JAMA Clinical Guidelines Synopsis summarizes the British Columbia Ministry of Health’s 2015 guidelines on clinical management of opioid use disorder in adults.

Box Section Ref ID

Guideline title Guideline for the Clinical Management of Opioid Addiction

Developer Vancouver Coastal Health, Providence Health Care, and Ministry of Health, British Columbia, Canada

Release date November 2015

Funding source Funded publicly through governmental grants

Target population Nonpregnant adult patients with opioid use disorder

Major recommendations

  • Opioid withdrawal alone is not recommended for treatment of opioid use disorder in most patients because of increased risks of overdose death and infectious disease, particularly HIV through intravenous drug use, following detoxification (moderate-quality evidence; strong recommendation).

  • In the absence of contraindications, medically supervised opioid agonist treatment should be offered to patients. Buprenorphine/naloxone is the preferred first-line treatment. Methadone is an alternative in certain patient populations (high-quality evidence; strong recommendation).

  • Psychosocial supports tailored to patient needs may be offered as an adjunct to medical treatment (moderate-quality evidence; conditional recommendation).

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