Patients with this result are at high risk for adverse outcomes related to illicit opioid use (for example: heroin and fentanyl) and are highly likely to meet DSM-5 criteria for an Opioid Use Disorder.
Display Title
Opioids Risk Level: High Risk for Opioid Use Disorder
Tool Type
Drugs of Abuse
Risk Level
High
Additional Resources
Opioid Use Resources
- Prescribe to Prevent
- Opioid Overdose Prevention Toolkit – SAMHSA
- Medication Assisted Treatment (MAT) Resources – SAMHSA
- Providers' Clinical Support System For Opioid Therapies – PCSS
- Providers’ Clinical Support System for Medication Assisted Treatment – PCSS
- National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use – ASAM
- Opioid Use Disorder Education Program – Harvard Medical School
- SAMHSA TIP 63: Medications for Opioid Use Disorder – SAMHSA
General Resources
- Screening, Brief Intervention & Referral to Treatment Training Manual – Yale School of Medicine
- Behavioral Health Treatment Services Locator – SAMHSA
- Motivational Interviewing Skills Practice – NIDA
- OARS Essential Communication Techniques – Oregon.gov
- Principles of Drug Addiction Treatment: A Research-Based Guide (3rd ed.) - Behavioral Therapies – NIDA
Suggested Action
The suggested intervention for this risk level is to confirm diagnosis through a clinical interview using the DSM-5 Opioid Use Disorder criteria as a guide.
- Express concern and recommend cessation;
- Use the FRAMES components and motivational interviewing techniques (see references for specific resources) to encourage engagement in treatment.
- Consider prescribing medications to treat moderate to severe Opioid Use Disorder.
- Office-based medication options include prescribing buprenorphine; and for patients who have achieved abstinence.
- If you do not or cannot prescribe medications at our office, either refer to an opioid treatment program (for methadone maintenance treatment) or to a buprenorphine prescriber (you may use SAMHSA Behavioral Health Treatment Services Locator).
- Provide on-site counseling or a referral for off-site counseling and/or support group to complement medical treatment.
- Educate on overdose prevention and prescribe/provide naloxone.
- Assess and manage any co-occurring problems, such as pain and depression, that may be impacting opioid use.
- Assess for Hepatitis-C and/or HIV infection risk, especially from injection use.
- Review any prescribed medications to identify those that may increase the risk of overdose (other opioids, benzodiazepines).
- Educate patient on risks associated with combining heroin with alcohol or other drugs.
- Advise not to use opioids and drive.
- Arrange follow-up.