University of Oklahoma Health Sciences Center

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Author/s:

Perry, C., Liberto, J., Milliken, C., Burden, J., Hagedorn, H., Atkinson, T., McKay, J. R., Mooney, L., Sall, J., Sasson, C., Saxon, A., Spevak, C., Gordon, A, J,, VA/DoD Guideline Development Group

Date Added:

March 22, 2022

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

March 22, 2022

URL:

The Management of Substance Use Disorders: Synopsis of the 2021 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M21-4011

PMID (1):

35313113

Keywords

Substance Use

Department of Veterans Affairs

Department of Defense

Clinical Practice Guideline

MeSH

Humans

Veterans

alcoholism

National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division

Algorithms

RPR Commentary

A synopsis of the VA guidelines for management of substance use disorders. James W. Mold, MD, MPH

Abstract

Description: In August 2021, leadership within the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved a joint clinical practice guideline (CPG) for the management of substance use disorders (SUDs). This synopsis summarizes key recommendations.

Methods: In March 2020, the VA/DoD Evidence-Based Practice Work Group assembled a team to update the 2015 VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders that included clinical stakeholders and conformed to the National Academy of Medicine's tenets for trustworthy CPGs. The guideline panel developed key questions, systematically searched and evaluated the literature, created two 1-page algorithms, and distilled 35 recommendations for care using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. This synopsis presents the recommendations that were believed to be the most clinically impactful.

Recommendations: The scope of the CPG is broad; however, this synopsis focuses on key recommendations for the management of alcohol use disorder, use of buprenorphine in opioid use disorder, contingency management, and use of technology and telehealth to manage patients remotely.

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