Engagement and Retention of Nonabstinent Patients in Substance Use Treatment: Clinical Consideration for Addiction Treatment Providers

Initiation, engagement, and retention in treatment are critical factors that impact long-term outcomes for substance use disorders (SUDs); early treatment engagement and longer durations of treatment predict better clinical outcomes. Despite this, patients are regularly dissuaded from initiating treatment until they commit to full sustained abstinence from all intoxicants, and too frequently are administratively discharged from SUD treatment programs during instances of substance use recurrence. This document was developed to provide SUD treatment programs and providers with guidance and support to: 1) address the complexities of patient nonabstinence during treatment; 2) reduce administrative discharges; and 3) implement strategies focused on lowering barriers to care to improve engagement and retention of nonabstinent patients in the continuum of care.

ASAM Clinical Considerations: Buprenorphine Treatment of Opioid Use Disorder for Individuals Using High-potency Synthetic Opioids

Treatment of opioid use disorder (OUD) with buprenorphine has evolved considerably in the last decade as the scale of the OUD epidemic has increased along with the emergence of high-potency synthetic opioids (HPSOs) and stimulants in the drug supply. These changes have outpaced the development of prospective research, so a clinical consideration document based on expert consensus is needed to address pressing clinical questions. This clinical considerations document based on a narrative literature review and expert consensus and will specifically address considerations for changes to the clinical practice of treatment of OUD with buprenorphine for individuals using HPSO.

COVID-19

While many states across the country are relaxing physical distancing and other restrictions put in place in response to COVID-19, people remain at risk for infection based on widespread community transmission and increasing population prevalence of the virus. As a result, the pandemic continues to impact the work of addiction treatment clinicians and programs as they strive to maintain safety for both staff and patients.

Integrating Tobacco Use Disorder Interventions in Addiction Treatment

The integration of tobacco-related services into addiction treatment can improve treatment outcomes, promote recovery, and reduce the well-established harms of ongoing tobacco use, including tobacco-related death and disease. This guide provides recommendations to integrate tobacco use Disorder interventions in addiction treatment.

Opioid Use and Opioid Use Disorder in Pregnancy

Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes. In general, a coordinated multidisciplinary approach without criminal sanctions has the best chance of helping infants and families.