Table 4.
Circumstances where OAT may not be preferred for OWS
| OAT undesirable/inappropriate/inadequate | OAT unavailable |
|---|---|
| • Mild OUD or physical dependence only ○ Patients with chronic pain | • Rural and other areas without OAT access |
| • Prior to treatment with naltrexone a | • Post overdose in naloxone‐treated patients |
| • Patients desiring opioid‐free therapy | • Criminal justice system |
| • Tapering off OAT maintenance during the lowest dosages before discontinuation | |
| • During OAT induction with buprenorphine when the previous opioid dose has been beyond about 80 mg of methadone daily |
OAT, opioid agonist therapy; OUD, opioid use disorder; OWS, opioid withdrawal symptoms.
a
As a bridge to naltrexone (opioid‐receptor antagonist) during opioid‐free withdrawal or during/following OAT‐assisted withdrawal.