VA/DoD Clinical Practice Guidelines for the Management of Substance Use Disorders
Adopting a standard set of clinical guidelines can help organizations and agencies to improve the care provided to individuals with substance use disorders by increasing both the quality and consistency of services. One of the most comprehensive and well-researched set of clinical practice guidelines for the management of substance use disorders was developed by the Department of Veterans Affairs and the Department of Defense (VA/DoD).
In August 2009, the VA/DoD released an updated version of Clinical Practice Guidelines for the Management of Substance Use Disorders. These guidelines include specific, step-by-step algorithms for treating substance use disorders that are applicable to providers in both primary and specialty care settings. The guidelines address treatment practices for a range of substance use disorders: from risky and hazardous use to substance dependence. While specifically developed for use with VA/DoD populations, the guidelines are based on research that has been conducted in a variety of different health care settings and are general enough to be applicable and appropriate for us in varied populations.
The VA/DoD guidelines include five separate modules that address care for patients with substance use disorders. The five modules included in the guidelines are:
Module A: Screening and Initial Assessment for Substance Use includes information on screening, brief intervention, and specialty referral considerations.
Module B: Management of SUD in Specialty SUD Care focuses on patients in need of further assessment or motivational enhancement or who are seeking remission.
Module C: Management of SUD in General Healthcare (including primary care) emphasizes earlier intervention for less severe SUD, or chronic disease management for patients unwilling or unable to engage in treatment in specialty SUD care or not yet ready to abstain.
Module P: Addiction-Focused Pharmacotherapy addresses use of medication approved by the Food and Drug Administration for the treatment of alcohol and opioid dependence.
Module S: Stabilization and Withdrawal Management addresses withdrawal
Each module includes straightforward, step-by-step instructions that outline a clear decision-making process for the treatment of patients with substance use disorders. Each module also includes a brief description of the research literature supporting each recommendation and a rating of the strength of the evidence supporting each recommendation.
The full report, VA/DoD Clinical Practice Guidelines for the Management of Substance Use Disorders can be found here:
A summary of the VA/DoD Guidelines can be found here: http://www.healthquality.va.gov/sud/sud_sum_6_1.pdf