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Treatment Programs for Opioid Use Disorders: A Review of Guidelines

Last updated: August 30, 2018
Project Number: RC1010-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What are the evidence-based guidelines regarding the use of opioid addiction programs for the treatment of adults who are reducing or discontinuing opioids or opioid substitution therapy?

Key Message

Six evidence-based guidelines were identified regarding the use of programs for the treatment of opioid use disorders in adults. Included guidelines provide recommendations regarding the safety and clinical effectiveness of programs that address treatment, implementation, and adherence enhancement strategies. Two Canadian guidelines recommend initiating opioid agonist treatment with buprenorphine/naloxone where feasible as a first-line treatment option. This was a strong recommendation based on high quality evidence. Alternative strategies are recommended where buprenorphine/naloxone is not feasible, or where contraindications are identified. Psychosocial interventions aimed at reducing illicit drug use during detoxification and following completion include fostering social support (with the service provider, with peer groups and with existing network of family and carers) and use of contingency management.