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Updated! SAMHSA TIP 63: Medications for Opioid Use Disorder

Publication Date: Aug 02, 2021

Treatment Improvement Protocol 63 For Healthcare and Addiction Professionals, Policymakers, Patients, and Families

This TIP reviews three Food and Drug Administration-approved medications for opioid use disorder treatment—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support people in recovery.  

As a reflection of SAMHSA’s commitment to ensuring that people with substance use disorders receive timely, relevant, high-quality care, SAMHSA in May 2021 revised certain areas of all five parts of this TIP to bring the content up to date and make it as useful to readers as possible. These changes will help provide readers with the latest information needed to understand medications for opioid use disorder.

Updates include: 

  • New statistics from SAMHSA, the Centers for Disease Control and Prevention, and other health authorities on opioid-related deaths, overdoses, accidents, and hospitalizations.
  • Updating the qualifications of practitioners who are eligible to apply for a waiver to prescribe buprenorphine (i.e., clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives) to include exceptions under the latest buprenorphine practice guidelines on obtaining a waiver.
  • Where needed, clarifying whether references to naltrexone refer to the oral formulation or the extended-release injectable formulation.
  • Adding recent citations that support induction onto extended-release naltrexone of people with positive urine tests for opioids so long as they pass the naloxone challenge.
  • Clarifying that naltrexone can result in decreased opioid cravings.

View or download TIP 63: Medications for Opioid Use Disorder here