Resource Center: Treatment Algorithm

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Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse, Treatment Improvement Protocol (TIP) Series 9
Description: 
Developed by a consensus panel, these guidelines provide treatment recommendations for patients with dual disorders.
Source: 
U.S. Department of Health and Human Services, SAMHSA
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PCSS-B Guidance: Treatment of Acute Pain in Patients Receiving Buprenorphine/Naloxone
Description: 
This article provides guidance on the management and treatment of acute pain in patients receiving buprenorphine/naloxone.
Source: 
Physician Clinical Support System (PCSS)
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Buprenorphine Dosing Algorithms

Description: 
A series of flow charts displaying the steps that should be followed when inducting a new patient into buprenorphine treatment.

Flow charts are included for patients addicted to short- and long-acting opioids, for non-physically dependent patients, and for patients switching from buprenorphine to buprenorphine/naloxone.

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ASAM Patient Placement Criteria

Description: 
The ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (Mee-Lee et al. 2001) lists the 5 basic levels of care available for adult substance users. These levels of care range from Early Intervention (for at-risk individuals) to Medically Managed Intensive Inpatient Treatment (for patients with severe disorders who require around-the-clock care). The Patient Placement Criteria classifies opioid maintenance therapy as a Level I treatment since it is most often conducted in outpatient settings.


According to the Patient Placement Criteria, the following 6 patient dimensions should be considered when formulating a treatment plan (Mee-Lee et al. 2001):

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PCSS-B Guidance: Treatment of Opioid Dependent Adolescents and Young Adults Using Sublingual Buprenorphine 
Description: 
This document discusses the evidence for buprenorphine treatment of opioid dependent adolescents and young adults. It provides treatment recommendations, and highlights special issues that should be considered when treating this special population.
Source: 
Physician Clinical Support System (PCSS)
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Day 1

Description: 
Dosing Flowchart for Patients Physically Dependent on Short-Acting Opioids

This dosing flow chart depicts clinical dosing guidelines for patients physically dependent on short-acting opioids such as heroin.

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Day 1

Description: 
Induction for Patients Physically Dependent on Long-Acting Opioids

This dosing flow chart depicts clinical dosing guidelines for patients physically dependent on long-acting opioids such as methadone.

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Day 2+

Description: 
Induction for Non-Physically Dependent Patients

This flow chart depicts clinical guidelines for Day 2 of induction for non-physically dependent patients.

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Buprenorphine Induction for Patients Physically Dependent on Short- or Long-Acting Opioids

Description: 
This dosing flow chart depicts clinical guidelines for patients who are physically dependent on short- or long- acting opioids.

Guidelines are provided for if the withdrawal symptoms are present since the last dose, if the withdrawal symptoms continue, if the withdrawal symptoms return, and establishing the daily dose.

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Days 2+

Description: 
Dosing Flowchart of Buprenorphine Induction for Patients Dependent on Short- or Long-Acting Opioids

This dosing flow chart depicts clinical guidelines for patients who are physically dependent on short- or long- acting opioids.

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