Trastorno por consumo de opioides — tratamiento con agonistas (metadona/buprenorfina)

Why / when / how

Agonist treatment reduces all-cause mortality and improves retention in treatment in people with opioid use disorder, as a harm-reduction strategy. The certainty of the evidence for the critical outcomes is moderate. This is why the recommendation is strong in favor, because the benefits clearly outweigh the risks.

Cautions

Before intervening on substance use and exposure to toxicants, assess the patient's consumption pattern, dependence, and clinical conditions, and individualize the approach. Discontinuing substances that produce physical dependence may require medical supervision because of the risk of a withdrawal syndrome, so it should not be stopped abruptly without assessment. Advise seeking professional care in the presence of any warning sign, including in crisis situations, and refer to specialized addiction treatment/environmental health services, according to the case. Reassess the course periodically.

Quantitative evidence