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

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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.

Background

For people with opioid use disorder and their care providers, a comprehensive assessment and care plan help to identify complications of opioid use and other physical, social, and mental health concerns. Care providers should give evidence-based information to the person about their condition, and they should assess their goals to determine the most appropriate expertise needed to provide them with comprehensive care. The care plan should be reassessed regularly until the person’s goals are met.

What This Quality Statement Means

For People With Opioid Use Disorder

If you are diagnosed with or identified as having opioid use disorder, and if you are ready to make a change, your care provider will do an assessment with you. They will ask about things like your use of opioids and any other drugs or alcohol, your physical health, your mental health, and any other concerns you may have. After doing this assessment, your care provider will work with you to make a care plan that addresses all of your needs. If you choose, your family can also help you make your care plan.

For Care Providers

If a person is diagnosed with or identified as having opioid use disorder, and if the person agrees, perform a comprehensive assessment and complete a care plan with the person as soon as possible. Continue to reassess the person during subsequent visits, and adjust the plan accordingly until the goals of the plan are met.

For Health Services

Ensure systems, processes, and resources are in place to allow care providers to perform comprehensive assessments and create care plans for people diagnosed with or identified as having opioid use disorder. This includes providing the time required for care providers to conduct comprehensive assessments and ensuring access to the resources necessary to develop and maintain or adjust care plans.

Quality Indicators

Process Indicators

Percentage of people diagnosed with or identified as having opioid use disorder who have a comprehensive assessment

Denominator: total number of people diagnosed with or identified as having opioid use disorder
Numerator: number of people in the denominator who have a comprehensive assessment
Data source: local data collection

Percentage of people diagnosed with or identified as having opioid use disorder who have a comprehensive assessment and a care plan

Denominator: total number of people diagnosed with or identified as having opioid use disorder who have a comprehensive assessment
Numerator: number of people in the denominator who have a care plan
Data source: local data collection

Percentage of people diagnosed with or identified as having opioid use disorder who have a care plan who developed their care plan in collaboration with their care provider

Denominator: total number of people diagnosed with or identified as having opioid use disorder who have a care plan
Numerator: number of people in the denominator who developed their care plan in collaboration with their care provider
Data source: local data collection

Definitions Used Within This Quality Statement

Comprehensive assessment

A comprehensive assessment should address, at a minimum, the following items:

The person’s goals for treatment
Opioid use and overdose risk
Physical health status and medical conditions, including chronic pain
Mental health (see Quality Statement 10)
Other substance use (e.g., alcohol, benzodiazepines, tobacco)
Potential infections resulting from drug use
Socioeconomic information
Trauma screen*
Family history of substance use and mental health disorders*
Resilience and strengths*
Biological testing (e.g., urine drug screens)*

*Secondary care providers (e.g., cardiologists, infectious disease specialists) are not expected to complete the entire comprehensive assessment. The asterisk indicates items that can be deferred as long as the secondary care provider refers the person to another provider who will complete the assessment. In urgent care settings, completion of the entire comprehensive assessment may need to be deferred until acute issues are addressed.

Care plan

When establishing a care plan with a person with opioid use disorder, care providers should aim to address the following:

Management of the person’s opioid use disorder, including the following:

Same-day access to harm reduction services (see Quality Statement 11)
Access to ongoing treatment within 3 days
Access to take home naloxone and to overdose education

Access to treatment for other current substance use (e.g., use of alcohol, benzodiazepines, tobacco)
Housing and occupational needs
Income support
Connection with a primary care provider
Psychological and pharmacological treatments for concurrent mental health disorders (see Quality Statement 10)

Evidence to Improve Care