This decision support tool is for people who want information about the role of medications in treating opioid use disorder. You can use the tool to help you:

  • Learn about medication-assisted treatment;
  • Compare your treatment options;
  • Decide which options are best for you and your recovery; and
  • Discuss your preferences with your provider.

This decision support tool does not:

  • Substitute for or replace professional advice;
  • Endorse any particular pathway to recovery;
  • Direct people’s treatment choices;
  • Tell you what to do; or
  • Have all the answers.

No single approach works for everyone. This decision support tool may help you make informed choices about treatment for opioid use disorder and find an approach that is right for you.

Is this decision support tool for you? This site is for people looking for information and also for people close to them, who may be:

  • Misusing pain medication, using narcotics, heroin, or other opioid drugs;
  • Considering getting help for opioid use disorder; or
  • Considering medications that help with recovery from opioid use disorder.

If any of the statements below apply, you are probably in the right place.

  • I have been told medications may help me stop using opioids.
  • I just want information.
  • I don’t want to stop using now, but maybe someday I will.
  • I have tried to stop several times.
  • I am reluctant to use medications because I want to be able to do this on my own.
  • I want a medication to help me through withdrawal.
  • I want to stop using with the help of medication, but I am not sure which one.
  • I am under pressure to stop using.
  • I have chronic pain and opioids have become a problem for me.
  • I am pregnant and want to stop using opioids.
  • I am pregnant and my doctor has recommended I start medication for opioid use disorder.
  • I am working with someone who wants to stop using opioids.

Learn more

Important information from SAMHSA

This decision support tool is for informational purposes only. The information provided is not intended to diagnose, treat, cure, or prevent any disease or condition, including opioid use disorder. SAMHSA does not approve or endorse any specific treatment. If you have a health condition or concern, contact a health care provider.

Decisions about treatment of opioid use disorder are the sole responsibility of you and your treatment providers. Not all the options presented may be appropriate for your situation. Talk with your treatment providers about your situation and the role of medication in your recovery from opioid use disorder.

Every effort is made to ensure the information in this decision support tool is accurate and up-to-date. However, medical information is continually changing and can become quickly outdated. Talk with your providers about the most recent research findings as they relate to your situation.

SAMHSA recognizes that widespread use of various medications to support addiction recovery is a new and rapidly changing practice. SAMHSA respects the diverse opinions of the recovery community on its use.

SAMHSA acknowledges that this electronic decision support tool does not explore all effective treatment approaches, alternative treatments, or recovery pathways for opioid use disorder. The purpose of this decision support tool is to make objective, research-based information accessible to individuals and families facing specific decisions about medication for opioid use disorder, rather than to promote any single treatment option.

SAMHSA emphasizes that evidence supports that medications are best used in combination with recovery support, lifestyle changes, and professional treatment.

Every effort has been made to provide functional links to useful online resources throughout this tool. Unfortunately, as other websites change, some of these links will stop working. If you encounter a link that does not work within this tool, please visit the Resources page to find a full citation for each recommended online resource. This will help you to find the resource using Google or another search engine.

Funders and Developers

Funders and Developers

This decision support tool was developed with funding from the federal Substance Abuse and Mental Health Services Administration (SAMHSA). It was prepared by the Center for Social Innovation with Advocates for Human Potential, Inc. under Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS); contract number HHSS 280201100002C, SAMHSA, U.S. Department of Health and Human Services (HHS). Cathy Nugent, Marsha Baker, Wanda Finch, and Deepa Avula served as the Contract Officer Representatives.

Disclaimer

The views, opinions, and content of this decision support tool are those of the authors and do not necessarily reflect the views, opinions, or policies of SAMHSA.

Public Domain Notice

All material in this decision support tool is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this material may not be reproduced or distributed for a fee without the specific written authorization of the Office of Communications, SAMHSA, HHS.

Electronic Access and Copies of the Material

This decision support tool and the accompanying handbook can be accessed electronically at the following Internet World Wide Web site: www.samhsa.gov/brss-tacs/shared-decision-making

Recommended Citation

Substance Abuse and Mental Health Services Administration. (2016). Decisions in Recovery: Treatment for Opioid Use Disorder. [Electronic Decision Support Tool] (HHS Pub No. SMA-16-4993), 2016. Available from: www.samhsa.gov/brss-tacs/shared-decision-making

Originating Office

Division of Pharmacologic Therapies, Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), 5600 Fishers Lane, Rockville, MD 20852. Phone: 1-800-789-2647. www.dpt.samhsa.gov/

Contributors

The following organizations and individuals participated in the development, review, and evaluation of this decision support tool.

Prime Contractor
Center for Social Innovation, Inc.
200 Reservoir St. Suite 202
Needham Heights, MA 02494
www.center4si.com

BRSS TACS Project Director
Livia Davis

Project Director, Developer
Dr. Wayne A. Centrone, Center for Social Innovation

Project Co-Director, Developer
Laurie Curtis, Advocates for Human Potential

Content Expert, Lead Writer, Editor
Niki Miller, Advocates for Human Potential

Development Team
Mike Fields, Nick Garza, Megan Grandin, Corey Grant, Baldwin Martinez, George Payne, Alex Shulman, Monica Terry, Lisa Carlucci Thomas, Michael Torocsik, Alan Zaitchik

Video Production
     Writer, Producer, Videographer, Editor
     Erika Simon, Center for Social Innovation
     Alexander Steacy, Center for Social Innovation

     Graphics, Photographer, Colorist
     Kristen Nichols, Center for Social Innovation

     Cast
     Tarah Johnson, Center for Social Innovation

     Music
     M. R. Miller

Subcontractor
Advocates for Human Potential, Inc.
41 State Street, Suite 500
Albany, NY 12207
Developers: Laurie Curtis, Niki Miller
www.ahpnet.com

Consultant
Lisa Mistler, M.D.
Assistant Professor of Psychiatry
Geisel School of Medicine at Dartmouth University
Hanover, NH 03755
lisa.a.mistler@dartmouth.edu

Special Thanks
Special appreciation to the following organizations for their support and contributions:

  • AIDS Resource Center of Wisconsin, Milwaukee, Wisconsin
  • American Association for the Treatment of Opioid Dependence (AATOD) 2012 National Conference, Las Vegas, Nevada
  • Harm Reduction Coalition, Oakland, California
  • HIV Education and Prevention Project, Alameda County, California
  • Medication Assisted Recovery Support (MARS) Project, New York, New York
  • National Alliance for Medication Assisted Recovery, New York, New York
  • Office-Based Buprenorphine Induction Clinic (OBIC) San Francisco General Hospital, San Francisco, California
  • Opioid Treatment Outpatient Program, San Francisco General Hospital, San Francisco, California
  • Outside In Medical Clinic, Portland, Oregon
  • Tom Waddell Health Center, San Francisco, California
  • West End Clinic, Massachusetts General Hospital, Boston, Massachusetts
The following individuals also contributed significantly to the development and content of this decision support tool:
  • Gavin Bart, Hennepin County Medical Center, Division of Addiction Medicine, Minneapolis, Minnesota
  • Thomas Freese, Pacific Southwest Addiction Technology Transfer Center (ATTC), Los Angeles, California
  • Walter Ginter, Medication Assisted Recovery Support (MARS) Project, New York, New York
  • Kurt Kemmling, National Alliance for Medication Assisted Recovery, Norwalk, Connecticut
  • Robert Lambert, Connecticut Counseling Center, Norwalk, Connecticut
  • Alan Mathis, Liberation Programs, Bridgeport/Norwalk, Connecticut
  • Brad Shapiro, Director of Opioid Treatment Outpatient Program, San Francisco General Hospital (SFGH), San Francisco, California
  • Scott Stokes, Director of Prevention Services, AIDS Resource Center of Wisconsin, Milwaukee, Wisconsin
  • Matt Tierney, Office-Based Buprenorphine Induction Clinic (OBIC), San Francisco, California
  • Nalan Ward, West End Clinic, Massachusetts General Hospital, Boston, Massachusetts
  • William White, Senior Research Consultant, Chestnut Health Systems, Bloomington, Illinois

Finally, special appreciation must go out to people in recovery from opioid use disorder from across the United States who were willing to share their hope, strength, and experience. Thank you.

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