{"id":7616,"date":"2018-03-03T17:35:33","date_gmt":"2018-03-04T00:35:33","guid":{"rendered":"https:\/\/crism.ca\/?page_id=7616"},"modified":"2026-09-23T09:56:52","modified_gmt":"2026-09-23T15:56:52","slug":"opioid-guideline","status":"publish","type":"page","link":"https:\/\/crism.ca\/fr\/opioid-guideline\/","title":{"rendered":"Lignes directrices nationales sur le trouble li\u00e9 \u00e0 l'usage d\u2019opio\u00efdes"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7616\" class=\"elementor elementor-7616\" wpc-filter-elementor-widget=\"1\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-35d066e elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"35d066e\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5ea62a4\" data-id=\"5ea62a4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-460d7c4 elementor-widget__width-initial elementor-widget-tablet__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-heading\" data-id=\"460d7c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">National Opioid Use Disorder Guideline<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-04bc901 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"04bc901\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-10a0576\" data-id=\"10a0576\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-44536bb2 elementor-widget elementor-widget-image\" data-id=\"44536bb2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1920\" height=\"2560\" src=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-scaled.webp\" class=\"attachment-full size-full wp-image-14915\" alt=\"\" srcset=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-scaled.webp 1920w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-225x300.webp 225w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-768x1024.webp 768w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-1152x1536.webp 1152w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/0f6bb473-17a6-43da-badf-3ad4aaeb113f-Pills4-1536x2048.webp 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6a77269\" data-id=\"6a77269\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3a4c3a2 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"3a4c3a2\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9b54875\" data-id=\"9b54875\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-87a4cb9 elementor-align-right elementor-mobile-align-center elementor-tablet-align-center elementor-widget elementor-widget-button\" data-id=\"87a4cb9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Date<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-c798c50\" data-id=\"c798c50\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5b35991e elementor-widget elementor-widget-text-editor\" data-id=\"5b35991e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>November 2024<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-a2adc87 elementor-widget elementor-widget-spacer\" data-id=\"a2adc87\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-5212ed6 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"5212ed6\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-bde8e69\" data-id=\"bde8e69\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-92fc5aa elementor-align-right elementor-mobile-align-center elementor-tablet-align-center elementor-widget elementor-widget-button\" data-id=\"92fc5aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Purpose<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-dae1e20\" data-id=\"dae1e20\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-60285f37 elementor-widget elementor-widget-text-editor\" data-id=\"60285f37\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">National Clinical Guidelines<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-a62dfe0 elementor-widget elementor-widget-spacer\" data-id=\"a62dfe0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-1e06b00 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"1e06b00\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-a25629b\" data-id=\"a25629b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1bba955 elementor-align-right elementor-mobile-align-center elementor-tablet-align-center elementor-widget elementor-widget-button\" data-id=\"1bba955\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Target Audience<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9784aa3\" data-id=\"9784aa3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7ea3513b elementor-widget elementor-widget-text-editor\" data-id=\"7ea3513b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This guideline is intended for use by health care providers, including physicians, nurse practitioners, pharmacists, clinical psychologists, social workers, medical educators, and clinical care case managers with or without specialized experience in addiction treatment.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2a523ea4 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"2a523ea4\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-53aba10e\" data-id=\"53aba10e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6f35719b elementor-widget elementor-widget-text-editor\" data-id=\"6f35719b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>In March 2018, North America was facing a rising opioid-related death crisis initially driven by greater availability and use of prescription opioids, followed by a change in the drug market with the introduction of illicitly manufactured fentanyl. This posed a significant threat to public health. In response, CRISM published the first Canadian national clinical practice guideline to assist clinicians in making informed decisions regarding the clinical management of opioid use disorder (OUD).<\/p><p>Recommendations were made in light of existing evidence on prioritizing available treatments and support for people with OUD. Over the past six years, additional measures have been implemented to help reduce the epidemic. In May 2018, the Government of Canada made a significant advancement in improving accessibility to treatment options by lifting restrictions on methadone prescriptions. As a result, subsection 561 class exemptions of the Controlled Drugs and Substances Act (CDSA) are no longer required to prescribe, administer or provide methadone, allowing better access to OUD treatment options.<\/p><p>The COVID-19 pandemic from March 2020 then marked an increase in opioid-related harms nationwide as access to essential services and support was restricted during that time, and the drug supply became increasingly toxic and volatile. According to data from the Public Health Agency of Canada (PHAC) and various authorities across the country, opioid-related harms and deaths significantly rose, and the number of fatalities has continued to exceed pre-pandemic levels ever since. To address these synergistic epidemics, additional measures and efforts, such as the expansion of telehealth services, five have been implemented to alleviate barriers and ensure continuous access to treatment and care for people with OUD.<\/p><p>In an ever-changing landscape of practices and policies, particularly following the COVID-19 pandemic, reviewing and incorporating the latest scientific and clinical evidence is crucial to ensuring optimal clinical management for individuals with OUD. As such, the current CRISM National Guideline for the Clinical Management of Opioid Use Disorder needs to be continuously updated to provide Canadian health care professionals with timely, comprehensive information and evidence-based recommendations on the most effective practices for the treatment of OUD.<\/p><p>In alignment with the Canadian government\u2019s objectives and CRISM\u2019s mission, the following are the 2024 updated national clinical recommendations. This practice guidance updates the 2018 version and incorporates peer-reviewed research published between January 2017 and August 2023. Clinical insights and values of persons with lived, and living experience (PWLLE) were also considered when developing these guidelines. This document aims to build consensus and support efforts to achieve the highest national standards of care for the clinical management of OUD.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1d56f2ee elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"1d56f2ee\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-52be77e1\" data-id=\"52be77e1\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-604419ff elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"604419ff\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-725aba80\" data-id=\"725aba80\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b625e40 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"b625e40\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\t2024 Clinical Guidelines\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-df99c34 elementor-widget elementor-widget-spacer\" data-id=\"df99c34\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-75644603 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"75644603\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-35d1a91e\" data-id=\"35d1a91e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-610ac33c elementor-widget elementor-widget-image\" data-id=\"610ac33c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2024\/11\/2024-Update-to-CRISM-Update-to-National-OUD-Guideline-20241111.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"648\" height=\"839\" src=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.41.14.png\" class=\"elementor-animation-grow attachment-large size-large wp-image-14899\" alt=\"\" srcset=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.41.14.png 648w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.41.14-232x300.png 232w\" sizes=\"(max-width: 648px) 100vw, 648px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6ffc311f elementor-align-center elementor-widget elementor-widget-button\" data-id=\"6ffc311f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/crism.ca\/wp-content\/uploads\/2024\/11\/2024-Update-to-CRISM-Update-to-National-OUD-Guideline-20241111.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download (EN)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-2f13e71a\" data-id=\"2f13e71a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6f59abd6 elementor-widget elementor-widget-image\" data-id=\"6f59abd6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/03\/241173-guide-1-at-f.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"648\" height=\"839\" src=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.43.47.png\" class=\"elementor-animation-grow attachment-large size-large wp-image-14902\" alt=\"\" srcset=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.43.47.png 648w, https:\/\/crism.ca\/wp-content\/uploads\/2025\/08\/Capture-decran-le-2025-08-21-a-12.43.47-232x300.png 232w\" sizes=\"(max-width: 648px) 100vw, 648px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-32488d68 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"32488d68\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/crism.ca\/wp-content\/uploads\/2025\/03\/241173-guide-1-at-f.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download (FR)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-343c4625 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"343c4625\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-25ec0594\" data-id=\"25ec0594\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-752c03f4 elementor-align-center elementor-mobile-align-center elementor-tablet-align-center elementor-widget elementor-widget-button\" data-id=\"752c03f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Summary of Recommandations (2024)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-59f056d3 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"59f056d3\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-32b124f\" data-id=\"32b124f\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9929ade elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"9929ade\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\tOpioid Agonist Therapies\u200b\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-38aa5157 elementor-widget elementor-widget-spacer\" data-id=\"38aa5157\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5c2a3281 elementor-widget elementor-widget-text-editor\" data-id=\"5c2a3281\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\"><strong>RECOMMENDATION 1 (UPDATED):<\/strong> Buprenorphine and methadone should both be considered as standard first-line treatment options for opioid agonist therapy (STRONG, HIGH)<\/span><\/p><ul><li><em>For people who initiate opioid agonist therapy with buprenorphine, clinicians should be aware of the higher risk of attrition after the first month of initiation and offer alternative opioid agonist medications in these circumstances (high certainty of evidence). <\/em><\/li><li><em>When considering methadone, clinicians should be aware of the higher risk of mortality during the first month compared to the remainder of the treatment period (moderate certainty of evidence).<\/em><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5854382c elementor-widget elementor-widget-text-editor\" data-id=\"5854382c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">RECOMMENDATION 2 (UPDATED): <\/span><\/strong><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">Opioid agonist therapy with slow-release oral morphine should be available and offered as a second-line treatment option. <\/span><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">(MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6712de6a elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"6712de6a\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-69cc654c\" data-id=\"69cc654c\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f827878 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"f827878\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\tWithdrawal Management Strategies\u200b\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ccfcb9f elementor-widget elementor-widget-spacer\" data-id=\"3ccfcb9f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-327258d elementor-widget elementor-widget-text-editor\" data-id=\"327258d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">RECOMMENDATION 3 (NO CHANGE): <\/span><\/strong><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">Patients with opioid use disorder should not be offered withdrawal management alone because of the increased rates of relapse, morbidity, and mortality. Concurrent long-term addiction treatment is recommended. <\/span><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">(MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-10a68c5a elementor-widget elementor-widget-text-editor\" data-id=\"10a68c5a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>\u00a0<\/strong><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\"><strong>RECOMMENDATION 4 (NO CHANGE):<\/strong> When withdrawal management alone is pursued, a supervised slow opioid agonist taper (depending on the patient) should be provided, with close follow-up, and opioid agonist therapy should immediately be offered if the risk of relapse emerges. (MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f3aa97e elementor-widget elementor-widget-text-editor\" data-id=\"3f3aa97e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>RECOMMENDATION 5 (NO CHANGE):<\/strong> For patients with a successful and sustained response to opioid agonist therapy who wish to discontinue opioid agonist therapy (i.e., medication cessation), clinicians should consider a slow taper approach (depending on the patient). Ongoing addiction care should be considered upon cessation of opioid use. <span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\">(MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5b7eb1a2 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"5b7eb1a2\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7d528878\" data-id=\"7d528878\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-064c2c5 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"064c2c5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\tPsychosocial and Harm Reduction Interventions\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-70e09536 elementor-widget elementor-widget-spacer\" data-id=\"70e09536\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5527f06b elementor-widget elementor-widget-text-editor\" data-id=\"5527f06b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\"><strong>RECOMMENDATION 6 (UPDATED): <\/strong>Psychosocial treatments, interventions, and supports can be offered as adjunct treatments to opioid agonist therapy to increase treatment retention.(MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d694699 elementor-widget elementor-widget-text-editor\" data-id=\"d694699\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\"><strong>RECOMMENDATION 7 (UPDATED): <\/strong>Psychosocial treatment should not be a mandatory component of standard treatment for opioid use disorder and should not prevent access to opioid agonist therapy. (MODERATE, STRONG)<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7e40c21 elementor-widget elementor-widget-text-editor\" data-id=\"7e40c21\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none\"><strong>RECOMMENDATION 8 (UPDATED): <\/strong>Harm reduction strategies should be offered as part of the continuum of care for patients with opioid use disorder.\u00a0(MODERATE, STRONG)<\/span><\/p><p><em>Current evidence supports the use of the following harm reduction programs: provision of sterile consumption equipment, overdose prevention education, and access to take-home naloxone kits.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7877fad2 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"7877fad2\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-57889774\" data-id=\"57889774\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9c7af47 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"9c7af47\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\tSpecial Considerations (NEW)\u200b\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1daa2f44 elementor-widget elementor-widget-spacer\" data-id=\"1daa2f44\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1121b793 elementor-widget elementor-widget-text-editor\" data-id=\"1121b793\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Alternative options:<\/strong> For patients who decline or are not on standard treatments for opioid use disorder and have withdrawn from opioids, oral naltrexone could be discussed as an adjunct pharmacological option.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6d2ec6dc elementor-widget elementor-widget-text-editor\" data-id=\"6d2ec6dc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Special populations:<\/strong> Pregnant people with opioid use disorder who are not in treatment should be encouraged to start a first-line treatment as soon as possible during pregnancy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5a0daa85 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"5a0daa85\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-576a6502\" data-id=\"576a6502\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-236d907 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"236d907\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\tAbout\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-28925127 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"28925127\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-2be05b0b\" data-id=\"2be05b0b\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3d2106c2 elementor-widget-mobile__width-inherit elementor-widget elementor-widget-heading\" data-id=\"3d2106c2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">CMAJ<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-741649fc elementor-widget elementor-widget-text-editor\" data-id=\"741649fc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>A synopsis of the Guideline was published in the Canadian Medical Association Journal\u00a0<em>(November 12, 2024).\u00a0<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-321b9bd1 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"321b9bd1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.cmaj.ca\/content\/196\/38\/E1280http:\/\/www.cmaj.ca\/content\/190\/9\/E247\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">English<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18043e10 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"18043e10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/crism.ca\/wp-content\/uploads\/2024\/11\/E1280.full_.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">PDF Version (EN)<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-09ce9c0 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"09ce9c0\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4abe154\" data-id=\"4abe154\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-f056856 elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"f056856\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-ff3d088\" data-id=\"ff3d088\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-01ae953 elementor-widget-divider--view-line_text elementor-widget-divider--element-align-left elementor-widget elementor-widget-divider\" data-id=\"01ae953\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateX_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:1,&quot;sizes&quot;:[]},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;],&quot;motion_fx_translateX_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}}}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t\t<span class=\"elementor-divider__text elementor-divider__element\">\n\t\t\t\t2018 Clinical Guidelines\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c37a9f elementor-widget elementor-widget-spacer\" data-id=\"7c37a9f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-76d5e4e elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"76d5e4e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-666e06d\" data-id=\"666e06d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f8e7afd elementor-widget elementor-widget-image\" data-id=\"f8e7afd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2018\/03\/CRISM_NationalGuideline_OUD-ENG.pdf\" target=\"_blank\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"606\" height=\"788\" 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data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li><a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2018\/03\/CRISM-Bup-nlx-info-sheet.pdf\" target=\"_blank\" rel=\"noopener\">Did you know? Buprenorphine\/Naloxone<\/a><\/li><li><a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2018\/03\/CRISM-SROM-info-sheet.pdf\" target=\"_blank\" rel=\"noopener\">Did you know? Slow-release oral morphine<\/a><\/li><li><a href=\"https:\/\/crism.ca\/wp-content\/uploads\/2018\/03\/CRISM-WDM-bulletin.pd\" target=\"_blank\" rel=\"noopener\">Withdrawal Management Safety Bulletin<\/a><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>National Opioid Use Disorder Guideline Date November 2024 Purpose National Clinical Guidelines Target Audience This guideline is intended for use by health care providers, including physicians, nurse practitioners, pharmacists, clinical psychologists, social workers, medical educators, and clinical care case managers with or without specialized experience in addiction treatment. In March 2018, North America was facing a rising opioid-related death crisis initially driven by greater availability and use of prescription opioids, followed by a change in the drug market with the introduction of illicitly manufactured fentanyl. This posed a significant threat to public health. In response, CRISM published the first Canadian national clinical practice guideline to assist clinicians in making informed decisions regarding the clinical management of opioid use disorder (OUD). Recommendations were made in light of existing evidence on prioritizing available treatments and support for people with OUD. Over the past six years, additional measures have been implemented to help reduce the epidemic. In May 2018, the Government of Canada made a significant advancement in improving accessibility to treatment options by lifting restrictions on methadone prescriptions. As a result, subsection 561 class exemptions of the Controlled Drugs and Substances Act (CDSA) are no longer required to prescribe, administer or provide methadone, allowing better access to OUD treatment options. The COVID-19 pandemic from March 2020 then marked an increase in opioid-related harms nationwide as access to essential services and support was restricted during that time, and the drug supply became increasingly toxic and volatile. According to data from the Public Health Agency of Canada (PHAC) and various authorities across the country, opioid-related harms and deaths significantly rose, and the number of fatalities has continued to exceed pre-pandemic levels ever since. To address these synergistic epidemics, additional measures and efforts, such as the expansion of telehealth services, five have been implemented to alleviate barriers and ensure continuous access to treatment and care for people with OUD. In an ever-changing landscape of practices and policies, particularly following the COVID-19 pandemic, reviewing and incorporating the latest scientific and clinical evidence is crucial to ensuring optimal clinical management for individuals with OUD. As such, the current CRISM National Guideline for the Clinical Management of Opioid Use Disorder needs to be continuously updated to provide Canadian health care professionals with timely, comprehensive information and evidence-based recommendations on the most effective practices for the treatment of OUD. In alignment with the Canadian government\u2019s objectives and CRISM\u2019s mission, the following are the 2024 updated national clinical recommendations. This practice guidance updates the 2018 version and incorporates peer-reviewed research published between January 2017 and August 2023. Clinical insights and values of persons with lived, and living experience (PWLLE) were also considered when developing these guidelines. This document aims to build consensus and support efforts to achieve the highest national standards of care for the clinical management of OUD. 2024 Clinical Guidelines Download (EN) Download (FR) Summary of Recommandations (2024) Opioid Agonist Therapies\u200b RECOMMENDATION 1 (UPDATED): Buprenorphine and methadone should both be considered as standard first-line treatment options for opioid agonist therapy (STRONG, HIGH) For people who initiate opioid agonist therapy with buprenorphine, clinicians should be aware of the higher risk of attrition after the first month of initiation and offer alternative opioid agonist medications in these circumstances (high certainty of evidence). When considering methadone, clinicians should be aware of the higher risk of mortality during the first month compared to the remainder of the treatment period (moderate certainty of evidence). RECOMMENDATION 2 (UPDATED): Opioid agonist therapy with slow-release oral morphine should be available and offered as a second-line treatment option. (MODERATE, STRONG) Withdrawal Management Strategies\u200b RECOMMENDATION 3 (NO CHANGE): Patients with opioid use disorder should not be offered withdrawal management alone because of the increased rates of relapse, morbidity, and mortality. Concurrent long-term addiction treatment is recommended. (MODERATE, STRONG) \u00a0RECOMMENDATION 4 (NO CHANGE): When withdrawal management alone is pursued, a supervised slow opioid agonist taper (depending on the patient) should be provided, with close follow-up, and opioid agonist therapy should immediately be offered if the risk of relapse emerges. (MODERATE, STRONG) RECOMMENDATION 5 (NO CHANGE): For patients with a successful and sustained response to opioid agonist therapy who wish to discontinue opioid agonist therapy (i.e., medication cessation), clinicians should consider a slow taper approach (depending on the patient). Ongoing addiction care should be considered upon cessation of opioid use. (MODERATE, STRONG) Psychosocial and Harm Reduction Interventions RECOMMENDATION 6 (UPDATED): Psychosocial treatments, interventions, and supports can be offered as adjunct treatments to opioid agonist therapy to increase treatment retention.(MODERATE, STRONG) RECOMMENDATION 7 (UPDATED): Psychosocial treatment should not be a mandatory component of standard treatment for opioid use disorder and should not prevent access to opioid agonist therapy. (MODERATE, STRONG) RECOMMENDATION 8 (UPDATED): Harm reduction strategies should be offered as part of the continuum of care for patients with opioid use disorder.\u00a0(MODERATE, STRONG) Current evidence supports the use of the following harm reduction programs: provision of sterile consumption equipment, overdose prevention education, and access to take-home naloxone kits. Special Considerations (NEW)\u200b Alternative options: For patients who decline or are not on standard treatments for opioid use disorder and have withdrawn from opioids, oral naltrexone could be discussed as an adjunct pharmacological option. Special populations: Pregnant people with opioid use disorder who are not in treatment should be encouraged to start a first-line treatment as soon as possible during pregnancy. About CMAJ A synopsis of the Guideline was published in the Canadian Medical Association Journal\u00a0(November 12, 2024).\u00a0 English PDF Version (EN) 2018 Clinical Guidelines Download (EN) Download (FR) CMAJ Publication (EN) PDF Version (EN) Recommendations (EN) Recommendations (FR) Supplemental Materials Did you know? Buprenorphine\/Naloxone Did you know? Slow-release oral morphine Withdrawal Management Safety Bulletin<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"footnotes":"","_members_access_role":[],"_members_access_error":"","_links_to":"","_links_to_target":""},"folder":[],"wf_page_folders":[365],"class_list":["post-7616","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>National Opioid Use Disorder Guideline - CRISM<\/title>\n<meta name=\"description\" content=\"CRISM 2024 National Opioid Use Disorder Guideline provides evidence-based recommendations for OAT, withdrawal management, and harm reduction.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crism.ca\/fr\/opioid-guideline\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"National Opioid Use Disorder Guideline - 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