• Christopher Perry, Joseph Liberto, Charles Milliken, Jennifer Burden, Hildi Hagedorn, Timothy Atkinson, James R McKay, Larissa Mooney, James Sall, Comilla Sasson, Andrew Saxon, Christopher Spevak, Adam J Gordon, and VA/DoD Guideline Development Group.
• National Capital Consortium, Bethesda, Maryland (C.P.).
• Ann. Intern. Med. 2022 May 1; 175 (5): 720-731.

DescriptionIn 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.MethodsIn 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.RecommendationsThe 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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