Opioid Use Disorder centers on saving lives and rebuilding function with medications plus practical supports. This page turns guidelines into same-day decisions: universal screening in primary care, ED, and specialty clinics; rapid buprenorphine induction (including micro-inductions), methadone linkage where available, and extended-release options when daily dosing is a barrier. We explain how to align goals—reduced overdose, stable sleep, work/school continuity—with plain-language consent, naloxone distribution, and safer-use education that meets patients where they are. If you’re exploring pathways at an opioid addiction conference, you’ll find stepwise algorithms for co-occurring depression/anxiety, alcohol, benzodiazepines, and stimulants; perioperative/pain protocols that prevent destabilization; and visit-flow templates that fit real clinics. Because fentanyl and polysubstance trends complicate induction and relapse, pair this page with Fentanyl and Overdose Science and Overdose Prevention Science for field-tested tactics.

Retention is engineered, not wished for. We hard-wire low-threshold access (walk-ins, evening/tele, mobile teams), pharmacy partnerships, and starter kits so the first dose happens today. Peers co-lead groups and solve practical barriers—IDs, benefits, transport, housing—while CBT/MI and contingency management strengthen skills and reward sober routines. Tobacco treatment is opt-out to improve mood, sleep, and survival; sleep/circadian repair boosts executive control and learning. Pregnancy and perinatal paths keep families together with non-punitive supports; justice interfaces provide pre-release bridges and immediate post-release appointments. Equity is a design constraint: interpreters, low-literacy materials, and community outreach bring care to encampments, shelters, pharmacies, and faith spaces. Dashboards track coverage (starts per 1,000), retention, overdoses, reversals, and quality of life by neighborhood and language; weekly huddles fix leaks fast. Measured by the only scoreboard that matters—fewer funerals and more functioning days—OUD programs can change the trajectory of communities.