Diagnosis and Treatment of Opioid Use Disorder

SECTION 4

Understanding and diagnosing different levels of substance use disorders enables tailored treatment, from outpatient counseling to intensive rehabilitation, improving outcomes and reducing relapse.

In correctional settings, providing safe, compassionate care for individuals with substance use disorder is crucial for rehabilitation and reducing recidivism.

By delivering evidence-based interventions and comprehensive support, healthcare providers address complex needs effectively, promoting successful reintegration into society post-release.

Diagnosing a Substance use disorder

DSM-5, drawing on extensive research, is a diagnostic tool utilized for diagnosing Substance Use Disorders (SUDs). It delineates 11 criteria stemming from substance misuse, categorized into impaired control, physical dependence, social problems, and risky use behaviors. Among these criteria is the tendency to use more of a substance than intended or for a longer duration than originally planned. This structured framework provided by DSM-5 assists healthcare professionals in accurately identifying and diagnosing SUDs.

It also includes cravings, tolerance, and withdrawal, scored as follows:

2-3 criteria = mild, 4-5 criteria = moderate

, 6+ criteria = severe

Are you familiar with the diagnostic information presented above? How comfortable are you diagnosing patients with SUDs? Your diagnosis is crucial because it will likely influence your treatment plan.

The four catagories and criteria.

Treatment of OUD

The importance of MOUD

MOUD refers to Medications for Opioid Use Disorder, an approach utilizing FDA-approved medications for treating opioid use disorder. Common medications include buprenorphine, methadone, and naltrexone. These treatments aim to normalize brain chemistry, block the euphoric effects of alcohol and opioids, alleviate physiological cravings, and restore bodily functions to normal levels.

The Effectiveness of MOUD

Medications for Opioid Use Disorder, such as methadone or buprenorphine, are recommended and are not to be confused with medical detox.

Without Medications for Opioid Use Disorder (MOUD), relapse rates exceed 90%, underscoring the importance of medication-assisted treatment. Additionally, MOUD has been shown to reduce mortality rates by 50%, highlighting its life-saving potential. Moreover, MOUD is associated with decreased rates of bacterial infections, HIV/HCV transmission, illicit drug use, and criminal activity, while simultaneously increasing rates of treatment retention. This comprehensive approach not only addresses opioid dependence but also improves overall health outcomes and societal well-being.

“Medication First” Approach

With a “mediation-first” approach:

  • Clients receive pharmacotherapy as quickly as possible, prior to lengthy assessment or treatment planning sessions;

  • Maintenance pharmacotherapy is delivered without arbitrary tapering or time limits;

  • Individualized psychosocial services are offered but not required as a condition of the pharmacotherapy; and

  • Pharmacotherapy is discontinued only if it appears to be worsening the client’s condition.

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