Fairbairn, Nadia and Ross, Josey and Trew, Michael and Meador, Karine and Turnbull, Jeff and MacDonald, Scott and Oviedo-Joekes, Eugenia and Le Foll, Bernard and Goyer, Marie-Ève and Perreault, Michel and Sutherland, Christy (2019) Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline. CMAJ, 191, (38), DOI: https://doi.org/10.1503/cmaj.190344.
External website: http://www.cmaj.ca/content/191/38/E1049
KEY POINTS
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Individuals with severe opioid use disorder who inject opioids and have not adequately benefited from oral opioid agonist treatment face substantial risks, including premature death, nonfatal overdose, blood-borne infectious diseases, violence and arrest.
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Individuals with severe opioid use disorder who inject opioids may not benefit adequately from oral opioid agonist treatment medications, for a variety of reasons.
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This guideline recommends that injectable opioid agonist treatment be considered for individuals with severe, treatment-refractory opioid use disorder and ongoing illicit (nonmedical or illegal or both) injection opioid use.
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For patients who are determined to be likely to benefit from injectable opioid agonist treatment, both diacetylmorphine and hydromorphone are acceptable treatment options.
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Injectable opioid agonist treatment should be provided as an open-ended treatment, with decisions to transition away from injectable opioid agonist treatment made collaboratively with the patient.
B Substances > Opioids (opiates) > Opioid product
HJ Treatment or recovery method > Substance disorder treatment method > Substance disorder drug therapy (pharmacological treatment)
HJ Treatment or recovery method > Substance disorder treatment method > Substance replacement method (substitution)
HJ Treatment or recovery method > Treatment outcome
J Health care, prevention, harm reduction and treatment > Patient / client care management
J Health care, prevention, harm reduction and treatment > Treatment and maintenance > Treatment factors
VA Geographic area > Canada
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