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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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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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