ASAM Provider Guide

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

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13 Î Patients who discontinue naltrexone treatment should be made aware of the increased risks associated with opioid overdose, and especially the increased risk of overdose death, if they return to illicit opioid use. • Treatment alternatives including methadone (see p. 8–9) and buprenorphine (see p. 10–11), as well as overdose prevention with naloxone (see p. 33) should be discussed with any patient choosing to discontinue treatment. Psychosocial Treatment in Conjunction with Medications for the Treatment of OUD Î MAJOR REVISION – Patients' psychosocial needs should be assessed, and patients should be offered or referred to psychosocial treatment, based on their individual needs, in conjunction with any pharmacotherapy for the treatment of, or prevention of relapse to, OUD. • However, a patient's decision to decline psychosocial treatment or the absence of available psychosocial treatment should not preclude or delay pharmacological treatment of OUD, with appropriate medication management. • Motivational interviewing or enhancement can be used to encourage patients to engage in psychosocial treatment services appropriate for addressing their individual needs. Î Treatment planning should include collaboration with qualified behavioral healthcare providers to determine the optimal type and intensity of psychosocial treatment and for renegotiation of the treatment plan for circumstances in which patients do not adhere to recommended plans for, or referrals to, psychosocial treatment.

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