Quality & Practice

What is the ASAM National Practice Guideline?

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Background

The American Society of Addiction Medicine (ASAM) developed the National Practice Guideline to provide information on evidence-based treatment of opioid use disorder. This guideline is the first to address all the FDA-approved medications available to treat addiction involving opioid use and opioid overdose - methadone, buprenorphine, naltrexone and naloxone - in a single document. It aims to help clinicians make evidence-based clinical decisions when prescribing pharmacotherapies to patients with opioid use disorder. 

Methodology

The National Practice Guideline was developed with support from Treatment Research Institute (TRI), using the RAND/UCLA Appropriateness Method (RAM), which combines scientific evidence with clinical knowledge to develop recommendations. The accumulation of evidence through clinical trials significantly lags behind practice for the treatment of addiction involving opioid use. The RAND/RAM allowed ASAM to develop a valid set of recommendations using this recognized methodology.

Summary of Recommendations

The National Practice Guideline makes recommendations on:

  • The clinical assessment and diagnosis of opioid use disorder;
  • How to choose among available treatment options for a given patient;
  • The treatment of opioid withdrawal;
  • The use of methadone, buprenorphine and naltrexone in the treatment of addiction involving opioid use;
  • Psychosocial treatment options; and
  • Treating opioid overdose with naloxone.

This comprehensive guideline also includes specific recommendations for special populations, including adolescents, pregnant women, individuals with pain, individuals with co-occuring psychiatric disorders and individuals in the criminal justice system.