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Understanding MOUD pharmacotherapy and reducing patients’ risk of overdose are the central requirements for providing medications for OUD. See the guidance below on these topics and for managing co-occurring conditions such as infectious diseases and chronic pain, as well as for monitoring your MOUD patient outcomes.
Pharmacotherapy
Explore the phases of prescribing medications for OUD, with a focus on buprenorphine. Consider person-centered care and shared decision-making, allowing patients to work with you to choose the most appropriate approach to their medication-based treatment for OUD and treatment setting.
Phase I: Starting Medication (Induction)
Initiation of MOUD involves assessing patient readiness, selecting appropriate medication and formulation, and ensuring safe induction protocols that minimize withdrawal and maximize comfort.
Phase II: Stabilization
Stabilization focuses on monitoring response to treatment, adjusting dosages as needed, and supporting adherence through regular follow-up and consideration of co-occurring conditions.
Phase III: Maintenance
Maintenance includes ongoing evaluation of treatment effectiveness, promotion of recovery goals, and preparation for long-term management or potential transitions in care.
Mitigating Overdose Risk
Overdose remains a leading cause of death among adults, especially those with OUD. Strategies for reducing overdose risk include rapid access to MOUD, naloxone distribution, and education for patients and families.
Educate About Overdose Risk
Educate all stakeholders about overdose risk factors—especially after abstinence or incarceration—to help them recognize high-risk situations and respond effectively.
Promote Naloxone Use
Encourage widespread access to and use of naloxone by patients and families, ideally providing kits directly and informing them of free or low-barrier sources.
Recognize and Respond to Overdose
Train staff, patients, and families to identify overdose symptoms and respond with naloxone, rescue breathing, and emergency services, while reviewing care plans post-overdose.
Infectious Diseases
People with OUD are at increased risk for infectious diseases such as hepatitis C, HIV, and skin infections. Recommendations for routine screening, education, and either onsite treatment or referral to care, while considering the interconnected nature of substance use and infectious diseases.
Patient Education
Educate patients with OUD on the heightened risk of infectious diseases like HIV and hepatitis due to substance use behaviors, along with counseling on prevention strategies.
Routine Screening
Routinely screen all patients with OUD for infectious diseases at intake, conduct risk assessments, and ensure timely treatment or referral for any identified conditions.
Wound Care and Prevention
Educate patients with OUD around prevention and hygiene, and routinely assess for skin and soft tissue infections, offering treatment or referrals as needed.
Chronic Pain
Chronic pain is common among individuals with OUD and requires careful, integrated management. Learn best practices for assessing pain, setting realistic goals, and incorporating nonpharmacologic therapies and behavioral health support into treatment plans.
Conduct a Thorough Assessment
A comprehensive pain assessment among patients with OUD evaluates physical, emotional, and functional effects using structured tools to guide individualized treatment planning.
Adjust the Treatment Plan
Chronic pain management in patients with OUD integrates non-opioid and nonpharmacologic therapies, addresses co-occurring mental health conditions, and tailors approaches based on the patient’s MOUD regimen and individual characteristics.
Anticipate Challenges with Hospitalizations and Procedures
Proactively coordinate care for patients receiving MOUD who undergo procedures, ensuring pain is managed safely without disrupting their treatment.
Monitoring Outcomes
Monitoring outcomes is essential for improving care and sustaining MOUD programs, tracking patient progress, using data to inform clinical decisions, and implementing quality improvement initiatives that foster a culture of learning and adaptation.
Select Patient Outcomes
Choose meaningful patient outcomes—such as treatment retention, overdose risk, and quality of life—that reflect both individual progress and overall program effectiveness.
Track Outcomes Data
Tracking and aggregating patient data using registries or EHR tools helps practices monitor trends, adjust care plans, and identify areas for improvement across the patient population.
Track Quality Improvement Measures
Select actionable quality measures and establish clear processes for collecting, analyzing, and using data to drive continuous improvement in MOUD delivery and patient outcomes.