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Home > Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline.

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) 7 p. DOI: https://doi.org/10.1503/cmaj.190344

URL: http://www.cmaj.ca/content/191/38/E1049


KEY POINTS

  • 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.

  • Individuals with severe opioid use disorder who inject opioids may not benefit adequately from oral opioid agonist treatment medications, for a variety of reasons.

  • 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.

  • For patients who are determined to be likely to benefit from injectable opioid agonist treatment, both diacetylmorphine and hydromorphone are acceptable treatment options.

  • 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.

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