ASAM Opioid Addiction Treatment GUIDELINES Apps and Pocket Guides brought to you courtesy of Guideline Central. Enjoy!
Issue link: https://eguideline.guidelinecentral.com/i/1019954
1 Diagnosis Assessment Î The first clinical priority should be given to identifying and making appropriate referral for any urgent or emergent medical or psychiatric problem(s), including drug-related impairment or overdose. Î Completion of the patient's medical history should include screening for concomitant medical conditions, including infectious diseases (hepatitis, HIV, and TB), acute trauma, and pregnancy. Î A physical examination should be completed as a component of the comprehensive assessment process. The prescriber (the clinician authorizing the use of a medication for the treatment of OUD) may conduct this physical examination him/herself, or, in accordance with the ASAM Standards 1 , ensure that a current physical examination is contained within the patient medical record before a patient is started on a new medication for the treatment of his/her addiction. Î Initial laboratory testing should include a complete blood count, liver function tests, and tests for hepatitis A, B, C and HIV. Testing for TB and sexually transmitted infections should also be considered. Hepatitis A and B vaccination should be offered, for those who are pregnant and the general population. Î The assessment of females presents special considerations regarding their reproductive health. Women of childbearing age should be tested for pregnancy, and all women of childbearing potential and age should be queried regarding methods of contraception given the increase in fertility that results from effective OUD treatment. Î Patients being evaluated for addiction involving opioid use, and/or for possible medication use in the treatment of OUD, should undergo (or have completed) an assessment of mental health status and possible psychiatric disorders (as outlined in the ASAM Standards of Care 2 ). Î Opioid use is often co-occurring with other substance related disorders. An evaluation of past and current substance use as well as a determination of the totality of substances that surround the addiction should be conducted. Î The use of marijuana, stimulants, or other addictive drugs should not be a reason to suspend OUD treatment. However, evidence demonstrates that patients who are actively using substances during OUD treatment have a poorer prognosis. • The use of alcohol, benzodiazepines and other sedative hypnotics may be a reason to suspend agonist treatment because of safety concerns related to respiratory depression.