ASAM Provider Guide

National Practice Guideline for the Treatment of Opioid Use Disorder - 2020 Update

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17 Common Dosing Advantages Disadvantages Range: 100mg to 300mg (monthly) Ceiling effects on respiratory depression; more rapid induction to steady state dose; less potential for euphoria (compared to methadone); considered safe for office- based treatment; improved social functioning ; associated with reductions in criminal activity, recidivism, and infectious disease acquisition and transmission Requires X-Waiver to prescribe; risk for overdose when combined with alcohol, benzodiazepines, or other sedatives Range: 8mg–32mg (weekly) or Range 64–128mg (monthly) 4 implants for 6 months of treatment Range: 25mg–50mg (daily) No risk for misuse or physiological dependence; no special regulatory requirements; improved social functioning ; associated with reductions in criminal activity and recidivism; and infectious disease acquisition and transmission Patients must be fully withdrawn from opioids before beginning treatment, lower retention in treatment, high rates of medication non-adherence, has not been demonstrated to reduce mortality (and may increase mortality risk aer medication discontinuation) Range: 380mg (monthly)

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