This section outlines several overarching principles of care, which apply to all recommendations and clinical care guidance offered in this guideline and, more broadly, to establishing positive partnerships with patients and families experiencing opioid-related harms. The principles of care are intended to serve as a general framework to support clinicians, care teams, and programs in the integration of care for OUD in their clinical practice. Clinicians and care teams are encouraged to review and adapt these principles of care as needed to fit their local context and resources available.
The principles of care identified here should not be considered an exhaustive list. There may be additional factors clinicians should take into account depending on practice setting, or when working with specific patients, families, communities, and populations (also see Section 4.0: Specific Populations).
Table 1. Summary of Principles of Care
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1. Patient-centred Care: Clinicians should strive to provide care that is respectful of the unique needs, values, and preferences of each patient. Patients should be empowered as experts in their own care.
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2. Social Determinants of Health: Opioid use disorder should be viewed within a larger societal framework that is shaped by inequities in the social determinants of health. Where appropriate, clinicians should aim to address disparities in the socioeconomic determinants of health by connecting patients with resources that meet these needs (e.g., housing, food/nutrition, financial assistance, employment).
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3. Indigenous Cultural Safety and Humility: Clinicians should make a meaningful commitment to providing culturally safe care and practicing cultural humility in order to establish safe and positive partnerships with Indigenous patients, families, and communities.
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| 4. Anti-racist Practices: Confronting and interrogating racist structures in health care and building awareness of one’s own position within oppressive systems can help improve care engagement and health outcomes for communities facing racism. |
| 5. Trauma- and Violence-informed Practice: Clinicians should be familiar with and incorporate the principles of trauma- and violence-informed practice in the care and clinical management of patients with OUD with the goal of creating a safe and respectful environment that minimizes the potential for harm and re-traumatization. |
| 6. Recovery and Self-defined Wellness: Clinicians should validate patients’ goals in OUD treatment and care, which may include recovery and/or self-defined wellness. |
| 7. Harm Reduction: A harm reduction-oriented approach to OUD care involves the acknowledgement and support of any steps taken by patients to improve their health and well-being. Clinicians should respect patients’ decisions and goals concerning substance use, and promote strategies to minimize opioid-related harms. |
| 8. Integrated Continuum of Care: Opioid use disorder is understood to be a chronic, relapsing and remitting condition. This guideline supports the use of a stepped and integrated approach, in which treatment options are continually adjusted to meet changing patient needs, circumstances, and goals. |
| 9. Comprehensive Health Management: Opioid use disorder should be managed within a broader framework of comprehensive health care and support, including routine and ongoing medical, mental health, and psychosocial assessments. |
| 10. Family and Social Circle Involvement in Care: Family and social circle involvement in treatment planning and decision-making should be encouraged whenever possible, and when deemed appropriate by the patient and their care team. |