Management of opioid use disorder: 2024 update to the national clinical practice guideline

Recommendations: From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consid...

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Bibliographic Details
Published in:CMAJ: Canadian Medical Association Journal 2024, Vol.196 (38), p.E1280
Main Authors: Yakovenko, Igor, Mukaneza, Yvette, Germe, Katuschia, Belliveau, Jacob, Fraleigh, Ross, Bach, Paxton, Poulin, Ginette, Selby, Peter, Goyer, Marie-Eve, Brothers, Thomas D, Rehm, Jurgen, Hodgins, David C, Stewart, Sherry H, Wood, Evan, Bruneau, Julie
Format: Report
Language:English
Subjects:
Medical research
Medicine, Experimental
Practice guidelines (Medicine)
Online Access:Get full text
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Summary:Recommendations: From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consideration; and 2 recommendations were revised. Key changes have arisen from substantial evidence supporting that methadone and buprenorphine are similarly effective, particularly in reducing opioid use and adverse events, and both are now considered preferred first-line treatment options. Slow-release oral morphine is recommended as a second-line option. Psychosocial interventions can be offered as adjunctive treatment but should not be mandatory. The guideline reaffirms the importance of avoiding withdrawal management as a standalone intervention and of incorporating evidence-based harm reduction services along the continuum of care.
ISSN:0820-3946
DOI:10.1503/cmaj.241173