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Medications for Opioid Use Disorder: For Healthcare and Addiction Professionals, Policymakers, Patients, and Families [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2018. (Treatment Improvement Protocol (TIP) Series, No. 63.)
This publication is provided for historical reference only and the information may be out of date.
For Healthcare Professionals
Part 3 of this Treatment Improvement Protocol (TIP) describes general principles of opioid use disorder (OUD) pharmacotherapy and discusses medication formulations, indications, and dosing for the three medications used to treat OUD—methadone, naltrexone, and buprenorphine.
KEY MESSAGES.
Part 3 of this TIP describes general principles of OUD pharmacotherapy and discusses medication formulations, indications, and dosing for the three Food and Drug Administration (FDA)-approved medications used to treat OUD—methadone, naltrexone, and buprenorphine. Part 3 also discusses patient management and monitoring in outpatient settings other than opioid treatment programs (OTPs) as well as medical management of patients with OUD in hospital settings.
The United States is experiencing an opioid addiction epidemic.1 In 2016, an estimated 2.1 million Americans had OUD.2 Illicit opioid use contributes to the development of OUD, the spread of HIV and hepatitis infections, and increasing numbers of overdose deaths.
OUD is a set of cognitive, behavioral, and physiological symptoms marked by an inability to stop opioid use despite negative consequences.3 When severe, it can present as a chronic, recurring condition with compulsive opioid use that is often termed “addiction.” It can cause serious physical and mental health, employment, legal, and family problems.
Each FDA-approved medication used to treat OUD can help patients achieve remission and begin or maintain recovery. Pharmacotherapy for OUD should be accompanied by individually tailored medical management and psychosocial and recovery support services as needed and wanted by patients to support their remission and recovery.
OPIOID-RELATED EMERGENCY DEPARTMENT visits nearly doubled from 2005–2014.4
Medication supports the efforts of the individual to achieve lasting recovery.
Exhibit 3.1 defines key terms in Part 3. For more definitions, see the glossary in Part 5 of this TIP.
EXHIBIT 3.1. Key Terms.
NOTE TO HEALTHCARE PROFESSIONALS
This TIP cannot replace sound clinical judgment and shared decision making based on careful patient assessment. Providers should familiarize themselves with FDA labeling of all OUD medications and current practices standards described here and in other resources such as the Providers' Clinical Support System (https://pcssmat.org).
This is an open-access report distributed under the terms of the Creative Commons Public Domain License. You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission.
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