opioidcds-12-patient-view
type: PlanDefinition
node role: treeRoot
resource.id:
  value: opioidcds-12-patient-view
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
    index: 0
    link: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
  meta.profile:
    value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
    index: 1
    link: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Id: opioidcds-12-patient-view Url: Recommendation #12 - Evidence-based Treatment for Patients with Opioid Use Disorder (patient-view) Version: 2022.1.0 Identifier: value: cdc-opioid-guidance Identifier: value: urn:oid:2.16.840.1.114222.34.15 Name: PlanDefinition_Recommendation_12_Patient_View Title: Recommendation #12 - Evidence-based Treatment for Patients with Opioid Use Disorder (patient-view) Status: active Experimental: false Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule display: ECA Rule Date: 2025-08-06 Publisher: CDC / Security Risk Solutions, Inc. (SRS) Description: Clinicians should offer or arrange treatment with evidence-based medications to treat patients with opioid use disorder. Detoxification on its own, without medications for opioid use disorder, is not recommended for opioid use disorder because of increased risks for resuming drug use, overdose, and overdose death. Logic Definitions: Library Name Name sequence OpioidCDSCommonConfig Age Less than 18 Years Is Enabled 0 // CDC 2022 General Inclusion Criteria define "Age Less than 18 Years Is Enabled": true Library Name Name sequence OpioidCDSCommon Patient 18 or Older? 1 define "Patient 18 or Older?": Config."Age Less than 18 Years Is Enabled" and AgeInYears() >= 18 Library Name Name sequence OpioidCDSCommonConfig Evidence Based Treatment Criteria For Opioid Use Disorder 2 // Recommendation 12 define "Evidence Based Treatment Criteria For Opioid Use Disorder": true Library Name Name sequence OpioidCDSCommonConfig Can the implementing EHR support queries for past medications by date range? 3 // Subroutine 2 - Past Medications define "Can the implementing EHR support queries for past medications by date range?": true Library Name Name sequence OpioidCDSREC12PatientView Opioid Use Disorder Lookback Period 4 define "Opioid Use Disorder Lookback Period": Interval[Today() - 90 days, Today()] Library Name Name sequence OpioidCDSREC12PatientView Not Receiving Eviden…
domain resource.contained: Library
  index: 0
  resource.id:
    value: effective-data-requirements
  library.name:
    value: EffectiveDataRequirements
  library.status:
    value: active
  library.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/library-type
      coding.code:
        value: module-definition
  library.related artifact:
    index: 0
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Library Common
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0
      link: 2022.1
      link: .0
  library.related artifact:
    index: 1
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Library Config
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig|2022.1.0
      link: 2022.1
      link: .0
  library.related artifact:
    index: 2
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Library FHIRHelpers
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1
      link: 4.0
      link: .1
  library.related artifact:
    index: 3
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set Buprenorphine and methadone medications
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-and-methadone-medications
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-and-methadone-medications
  library.related artifact:
    index: 4
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set Encounter Diagnosis Condition Category
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
  library.related artifact:
    index: 5
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set Problem List Condition Category
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
  library.related artifact:
    index: 6
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set US Core Health Concern Condition Category
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
  library.related artifact:
    index: 7
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set Opioid misuse disorders
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-misuse-disorders
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-misuse-disorders
  library.related artifact:
    index: 8
    related artifact.type:
      value: depends-on
    related artifact.display:
      value: Value set Active Condition
    related artifact.resource:
      value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active
      link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active
  library.parameter:
    index: 0
    parameter definition.name:
      value: Is Recommendation Applicable?
    parameter definition.use:
      value: out
    parameter definition.min:
      value: 0
    parameter definition.max:
      value: 1
    parameter definition.type:
      value: boolean
  library.data requirement:
    index: 0
    data requirement.type:
      value: Patient
    data requirement.profile:
      value: http://hl7.org/fhir/StructureDefinition/Patient
      index: 0
      link: http://hl7.org/fhir/StructureDefinition/Patient
  library.data requirement:
    index: 1
    data requirement.type:
      value: MedicationRequest
    data requirement.profile:
      value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
      index: 0
      link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
    data requirement.must support:
      value: medication
      index: 0
    data requirement.must support:
      value: status
      index: 1
    data requirement.must support:
      value: authoredOn
      index: 2
    data requirement.code filter:
      index: 0
      data requirement.code filter.path:
        value: medication
      data requirement.code filter.value set:
        value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-and-methadone-medications
        link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-and-methadone-medications
  library.data requirement:
    index: 2
    data requirement.type:
      value: MedicationRequest
    data requirement.profile:
      value: http://hl7.org/fhir/StructureDefinition/MedicationRequest
      index: 0
      link: http://hl7.org/fhir/StructureDefinition/MedicationRequest
    data requirement.must support:
      value: medication.reference
      index: 0
    data requirement.must support:
      value: status
      index: 1
    data requirement.must support:
      value: authoredOn
      index: 2
  library.data requirement:
    index: 3
    data requirement.type:
      value: Medication
    data requirement.profile:
      value: http://hl7.org/fhir/StructureDefinition/Medication
      index: 0
      link: http://hl7.org/fhir/StructureDefinition/Medication
    data requirement.must support:
      value: id
      index: 0
    data requirement.must support:
      value: code
      index: 1
  library.data requirement:
    index: 4
    data requirement.type:
      value: Condition
    data requirement.profile:
      value: http://hl7.org/fhir/StructureDefinition/Condition
      index: 0
      link: http://hl7.org/fhir/StructureDefinition/Condition
    data requirement.must support:
      value: category
      index: 0

value: code
index: 1

value: clinicalStatus
index: 2

value: recordedDate
index: 3

index: 0
data requirement.code filter.path:
  value: category
data requirement.code filter.value set:
  value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
  link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category

index: 5
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: 0
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: category
  index: 0
data requirement.must support:
  value: code
  index: 1
data requirement.must support:
  value: clinicalStatus
  index: 2
data requirement.must support:
  value: recordedDate
  index: 3
data requirement.code filter:
  index: 0
  data requirement.code filter.path:
    value: category
  data requirement.code filter.value set:
    value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
    link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category

index: 6
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: 0
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: category
  index: 0
data requirement.must support:
  value: code
  index: 1
data requirement.must support:
  value: clinicalStatus
  index: 2
data requirement.must support:
  value: recordedDate
  index: 3
data requirement.code filter:
  index: 0
  data requirement.code filter.path:
    value: category
  data requirement.code filter.value set:
    value: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
    link: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category

index: 0
extension.url:
  value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
extension.value code:
  value: shareable

index: 1
extension.url:
  value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
extension.value code:
  value: computable

index: 2
extension.url:
  value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
extension.value code:
  value: executable

index: 3
extension.url:
  value: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
extension.value code:
  value: publishable

index: 4
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSCommonConfig
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Age Less than 18 Years Is Enabled
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: // CDC 2022 General Inclusion Criteria define "Age Less than 18 Years Is Enabled": true
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 0
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 5
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSCommon
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Patient 18 or Older?
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Patient 18 or Older?": Config."Age Less than 18 Years Is Enabled" and AgeInYears() >= 18
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 1
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 6
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSCommonConfig
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Evidence Based Treatment Criteria For Opioid Use Disorder
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: // Recommendation 12 define "Evidence Based Treatment Criteria For Opioid Use Disorder": true
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 2
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 7
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSCommonConfig
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Can the implementing EHR support queries for past medications by date range?
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: // Subroutine 2 - Past Medications define "Can the implementing EHR support queries for past medications by date range?": true
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 3
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 8
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Opioid Use Disorder Lookback Period
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Opioid Use Disorder Lookback Period": Interval[Today() - 90 days, Today()]
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 4
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 9
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Not Receiving Evidence-Based Treatment for Opioid Use Disorder
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Not Receiving Evidence-Based Treatment for Opioid Use Disorder": Config."Evidence Based Treatment Criteria For Opioid Use Disorder" and not ( if Config."Can the implementing EHR support queries for past medications by date range?" then exists ( [MedicationRequest: Common."Buprenorphine and methadone medications"] MR where MR.status in { 'active', 'completed' } and date from MR.authoredOn during day of "Opioid Use Disorder Lookback Period" ) else true /* update 2022 removes "behavioral therapy condition" or exists ( [Procedure: Common."Substance misuse behavioral counseling"] P where P.status ~ 'completed' and ( case when P.performed is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime), FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime)] when P.performed is FHIR.Period then FHIRHelpers.ToInterval(P.performed as FHIR.Period) else null as Interval<DateTime> end ) during day of "Opioid Use Disorder Lookback Period" )*/ )
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 5
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 10
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSCommon
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: US Core-Categorized Conditions
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: // 3. Medications indicating end of life /* or exists ( "Medications Indicating End of Life" ) */ define "US Core-Categorized Conditions": [Condition: category in "Encounter Diagnosis Condition Category"] union [Condition: category in "Problem List Condition Category"] union [Condition: category in "US Core Health Concern Condition Category"]
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 6
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 11
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Presence of Diagnosis of Opioid Use Disorder
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Presence of Diagnosis of Opioid Use Disorder": exists ( Common."US Core-Categorized Conditions" C where C.code in Common."Opioid misuse disorders" and C.clinicalStatus in Common."Active Condition" and date from C.recordedDate during day of "Opioid Use Disorder Lookback Period" )
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 7
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 12
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Positive Result from Opioid Use Disorder Evaluation Tool
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Positive Result from Opioid Use Disorder Evaluation Tool": true
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 8
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 13
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Inclusion Criteria
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Inclusion Criteria": Common."Patient 18 or Older?" and "Not Receiving Evidence-Based Treatment for Opioid Use Disorder" and "Presence of Diagnosis of Opioid Use Disorder" and "Positive Result from Opioid Use Disorder Evaluation Tool"
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 9
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 14
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Exclusion Criteria
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Exclusion Criteria": false
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 10
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 15
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: OpioidCDSREC12PatientView
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: Is Recommendation Applicable?
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 11
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 16
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value string): value.value
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 12
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 17
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: ToConcept
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 13
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 18
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: ToCode
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 14
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 19
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value MedicationRequestStatus): value.value
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 15
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 20
element.extension:
  index: 0
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: 1
  extension.url:
    value: name
  extension.value string:
    value: ToDateTime
element.extension:
  index: 2
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDateTime(value dateTime): value.value
element.extension:
  index: 3
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 16
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: 21
element.id:
  value: effective-data-requirements
extension.url:
  value: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension.value canonical:
  value: #effective-data-requirements

index: 22
extension.url:
  value: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
extension.value reference:
  link: http://fhir.org/guides/cdc/opioid-cds/Device/cqf-tooling
  reference.reference:
    value: Device/cqf-tooling

index: 0
identifier.use:
  value: official
identifier.value:
  value: cdc-opioid-guidance

index: 1
identifier.system:
  value: urn:ietf:rfc:3986
identifier.value:
  value: urn:oid:2.16.840.1.114222.34.15

value: 2022.1.0

value: PlanDefinition_Recommendation_12_Patient_View

value: Recommendation #12 - Evidence-based Treatment for Patients with Opioid Use Disorder (patient-view)

codeable concept.coding:
  index: 0
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/plan-definition-type
  coding.code:
    value: eca-rule
  coding.display:
    value: ECA Rule

value: active

value: false

value: 2025-08-06

value: CDC / Security Risk Solutions, Inc. (SRS)

index: 0
contact detail.telecom:
  index: 0
  contact point.system:
    value: url
  contact point.value:
    value: https://www.securityrisksolutions.com

value: Clinicians should offer or arrange treatment with evidence-based medications to treat patients with opioid use disorder. Detoxification on its own, without medications for opioid use disorder, is not recommended for opioid use disorder because of increased risks for resuming drug use, overdose, and overdose death.

index: 0
usage context.code:
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/usage-context-type
  coding.code:
    value: focus
  coding.display:
    value: Clinical Focus
usage context.value codeable concept:
  codeable concept.coding: http://snomed.info/id/1336192000
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 1336192000
    coding.display:
      value: Opioid use disorder (disorder)

value: The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.

value: Medication treatment of opioid use disorder has been associated with reduced risk for overdose and overall deaths. Identification of opioid use disorder represents an opportunity for a clinician to initiate potentially life-saving interventions, and the clinician should collaborate with the patient regarding their safety to increase the likelihood of successful treatment.

value: © CDC 2016+.

index: 0
codeable concept.text:
  value: Opioid Prescribing

index: 0
contact detail.name:
  value: Kensaku Kawamoto, MD, PhD, MHS

index: 1
contact detail.name:
  value: Bryn Rhodes

index: 2
contact detail.name:
  value: Floyd Eisenberg, MD, MPH

index: 3
contact detail.name:
  value: Robert McClure, MD, MPH

index: 0
related artifact.type:
  value: documentation
related artifact.display:
  value: 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain
related artifact.url:
  value: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
related artifact.document:
  attachment.url:
    value: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm

value: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC12PatientView
index: 0
link: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC12PatientView

index: 0
element.extension:
  index: 0
  extension.url:
    value: http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation
  extension.value codeable concept:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/recommendation-strength
      coding.code:
        value: strong
      coding.display:
        value: Strong
element.extension:
  index: 1
  extension.url:
    value: http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence
  extension.value codeable concept:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/evidence-quality
      coding.code:
        value: high
      coding.display:
        value: High quality
plan definition.action.title:
  value: Offer Evidence-based Medications to Treat Patients with Opioid Use Disorder
plan definition.action.description:
  value: For patients diagnosed with opioid use disorder, consider opioid agonist or partial agonist treatment with methadone or buprenorphine maintenance therapy. Detoxification on its own, without medications for opioid use disorder, is not recommended for opioid use disorder because of increased risks of resuming drug use, overdose, and overdose death. For guidance regarding diagnosing and treating opioid use disorder, see [Recommendation 12 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=evidence%20type%3A%201).-,Implementation%20Considerations,-Although%20stigma%20can). [CDC recommends against releasing patients from care due to diagnosis of opioid use disorder](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=opioid%20use%20disorder.-,Clinicians%20should%20not%20dismiss%20patients%20from%20their%20practice%20because%20of%20opioid%20use%20disorder%20because%20this%20can%20adversely%20affect%20patient%20safety.,-Medication%20treatment%20of). [MME conversion factors should not be applied to dosage decisions related to the management of opioid use disorder](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=These%20conversion%20factors%20should%20not%20be%20applied%20to%20dosage%20decisions%20related%20to%20the%20management%20of%20opioid%20use%20disorder.). [Do not use the calculated dose in MMEs to determine the doses to use when converting one opioid to another; when converting opioids, the new opioid is typically dosed at a substantially lower dose than the calculated MME dose to avoid overdose because of incomplete cross-tolerance and individual variability in opioid pharmacokinetics](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=Do%20not%20use%20the,variability%20in%20opioid%20pharmacokinetics.). Consult the FDA approved product labeling for specific guidance on medications.
plan definition.action.priority:
  value: urgent
plan definition.action.trigger:
  index: 0
  trigger definition.type:
    value: named-event
  trigger definition.name:
    value: patient-view
plan definition.action.condition:
  index: 0
  plan definition.action.condition.kind:
    value: applicability
  plan definition.action.condition.expression:
    expression.description:
      value: Check whether the patient is 18 or older with an active condition of opioid misuse disorder and doesn't have an active prescription (order) for buprenorphine or methadone medications.
    expression.language:
      value: text/cql.identifier
    expression.expression:
      value: Is Recommendation Applicable?
plan definition.action.grouping behavior:
  value: visual-group
plan definition.action.selection behavior:
  value: any
plan definition.action.action:
  index: 0
  plan definition.action.description:
    value: Snooze* - Patient already provided medication elsewhere to treat opioid use disorder, snooze 3 months
plan definition.action.action:
  index: 1
  plan definition.action.description:
    value: Snooze* - Patient declined medication therapy, snooze 3 months
plan definition.action.action:
  index: 2
  plan definition.action.description:
    value: Document - Will order medication to treat opioid use disorder
plan definition.action.action:
  index: 3
  plan definition.action.description:
    value: Refer - Will refer patient to SUD specialist
plan definition.action.action:
  index: 4
  plan definition.action.description:
    value: Snooze* - N/A see comments, snooze 3 months