Treatment algorithm for opioid use disorder. Treatment algorithm for opioid use disorder. Note: A particular medication may not be indicated for a variety of reasons, including ineffectiveness or medical contraindication, comorbidities, drug–drug interactions, patient preference and specific circumstances, and prescriber’s experience. Any treatment for opioid use disorder, but particularly slow agonist tapers, should incorporate evidence-based psychosocial interventions with qualified professionals, motivational interviewing, long-term monitoring of substance use, provision of comprehensive primary care, and referrals to psychosocial treatment interventions and psychosocial supports as appropriate, with specialist care as required, to optimize physical and mental wellness as the patient progresses in recovery. Withdrawal management (formerly “detoxification”) without linkage to long-term addiction treatment is to be avoided, and patients desiring such approach should be informed of risks and encouraged toward other treatment options that would suit their circumstances. DSM-5 = Diagnostic and Statistical Manual of Mental Disorders, fifth edition.74 Julie Bruneau et al. CMAJ 2018;190:E247-E257 ©2018 by Canadian Medical Association