Opioid Use Disorder (Opioid Addiction)

Care for People 16 Years of Age and Older

Click below to see a list of brief quality statements and scroll down for more information.

Quality Statements in Brief

Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.

Quality Statement 1: Identifying and Diagnosing Opioid Use Disorder
People at risk of opioid use disorder are asked about their opioid use and are further assessed as appropriate.

Quality Statement 2: Comprehensive Assessment and Collaborative Care Plan
People diagnosed with or identified as having opioid use disorder have a comprehensive assessment and a care plan developed in collaboration with their care providers.

Quality Statement 3: Addressing Physical Health, Mental Health, Additional Addiction Treatment Needs, and Social Needs
People with opioid use disorder have integrated, concurrent, culturally safe management of their physical health, mental health, additional addiction treatment needs, and social needs.

Quality Statement 4: Information to Participate in Care
People with opioid use disorder are provided with information to enable them to participate in their care. If their family is involved, they are also provided with this information.

Quality Statement 5: Opioid Agonist Therapy as First-Line Treatment
People with opioid use disorder are informed that treatment that includes opioid agonist therapy is safer and more effective than treatments that do not include opioid agonist therapy.

Quality Statement 6: Access to Opioid Agonist Therapy
People diagnosed with or identified as having opioid use disorder have access to opioid agonist therapy as soon as possible, within a maximum of 3 days.

Quality Statement 7: Treatment of Opioid Withdrawal Symptoms
People with opioid use disorder who are in moderate or severe withdrawal from opioids are offered relief of their symptoms with buprenorphine/naloxone within 2 hours.

Quality Statement 8: Access to Take-Home Naloxone and to Overdose Education
People with opioid use disorder and their families have immediate access to take-home naloxone and to overdose education.

Quality Statement 9: Tapering Off of Opioid Agonist Therapy
People who have achieved sustained stability on opioid agonist therapy who wish to taper off are supported in a collaborative slow taper if clinically appropriate.

Quality Statement 10: Concurrent Mental Health Disorders
People with opioid use disorder who also have a mental health disorder are offered concurrent treatment for their mental health disorder.

Quality Statement 11: Harm Reduction
People who use opioids have same-day access to harm reduction services. A comprehensive harm reduction approach includes education, safe supplies, infectious disease testing, vaccinations, appropriate referrals, and supervised consumption services.

Resources Quality Statements Advisory Committee About

1

Identifying and Diagnosing Opioid Use Disorder

People at risk of opioid use disorder are asked about their opioid use and are further assessed as appropriate.

Background

There is no evidence supporting universal screening for opioid use disorder. However, people with selected characteristics that put them at higher risk for opioid use disorder (see definition) should be asked, with sensitivity and respect, about their opioid use. If a person states that they are using opioids, their care provider should engage them in a discussion regarding the type of opioid they are using, the method of administration, the frequency of administration, and the quantity of opioids they use. If it is possible that a person’s opioid use is causing them significant impairment or distress, the person should be assessed for opioid use disorder via the most current Diagnostic and Statistical Manual of Mental Disorders criteria.

What This Quality Statement Means

For People With Opioid Use Disorder

If you or your care provider are worried that opioids are having a negative impact on your life, the first step is to talk with your care provider about your opioid use. These opioids might be ones you are using recreationally or ones that were prescribed to you. Your care provider should ask you how you take opioids, how often you take them, and what amount you are taking. Your care provider should not judge you and should treat you with care and respect. The purpose of this conversation is to help you get better, not to get you in trouble.

For Care Providers

People at risk of opioid use disorder should be screened and, if necessary, provided with a more thorough assessment for a possible diagnosis of opioid use disorder.

For Health Services

Systems and resources should be in place to allow care providers to screen all those at risk of opioid use disorder.

Quality Indicators

Process Indicator

Percentage of people at risk of opioid use disorder who are asked about their opioid use

Denominator: total number of people identified as having a characteristic that puts them at risk of opioid use disorder (see definition)
Numerator: number of people in the denominator who are asked about their opioid use (type of opioid they are using, method of administration, frequency of administration, and quantity being used)
Data source: local data collection

Definitions Used Within This Quality Statement

People at risk of opioid use disorder

Characteristics that put people at higher risk for opioid use disorder and that suggest they may be candidates for screening include the following:

Receive care in or have a history of involvement with the criminal justice system
Receive care in a mental health setting
Have been prescribed long-term opioid therapy for chronic pain (see the quality standard Opioid Prescribing for Chronic Pain)
Present with symptoms that suggest the possibility of opioid use disorder; for example, medical complications related to injection drug use (e.g., skin infections, abscesses, endocarditis, premature valve disease)
Have alcohol use disorder
Have substance use disorder
Have experienced psychological trauma and/or adverse childhood experiences, including intergenerational trauma

Evidence to Improve Care