The American Society of Addiction Medicine (ASAM) is the standard-setting body for clinical care of substance use disorder patients. Their guidelines govern all parts of addiction medicine, including the most medically challenging portion of addiction treatment, the process of physically withdrawing from drugs.
This article, the second in a series of articles about ASAM standards of care, discusses the components of effective withdrawal management in addiction medicine practice.
“The most effective approach to treating a patient who has withdrawal is to prescribe a long-lasting oral opioid (usually methadone or buprenorphine) to relieve symptoms and then gradually reduce the dose to allow the patient to adjust to the absence of an opioid.”
Marc A. Schuckit, M.D.
The New England Journal of Medicine
From a clinician’s perspective, managing patient withdrawal is only the first step toward recovery. Medically, it is the most difficult and risky stage of treatment. The physician tasked with overseeing the process must determine what type of pharmaceutical management is most effective: agonist, partial agonist, or antagonist maintenance.
ASAM provides three key standards for assessing and managing withdrawal in addiction treatment settings:
While these are general standards of care, other governing bodies, such as the World Health Organization (WHO) provide additional guidelines that may be helpful for addiction treatment.
The WHO Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings offers clinicians additional guidelines for the treatment of withdrawal symptoms, including:
SAMHSA also offers additional clinical guidelines for withdrawal management in addiction treatment including recommendations for dispersal of buprenorphine and naloxone treatment.
Addiction treatment physicians must adhere to these clinical guidelines both as an ethical imperative and as a medical necessity.
Are you looking for a facility that provides appropriate withdrawal management for your patients? Contact us to find out more about referring patients to our facilities.