ASAM Pocket Guidelines and Patient Guide

ASAM Opioid Use Disorder Patient Guide 2025

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17 FENTANYL: SPECIAL CONSIDERATIONS • As fentanyl and other high potency opioids have become more common there has been a rapid increase in overdose deaths. • Patients who have been using fentanyl and similar drugs may have different treatment needs. For example, they may be at risk for more severe withdrawal. They may need a higher level of support to start medication, or they may need a higher medication dose. • For some patients who have been using fentanyl, It may be more difficult to begin buprenorphine. Their doctor may recommend: » A more intensive treatment setting, such as residential treatment » An extended-release formulation of buprenorphine » Methadone

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