Injectable Opioid Agonist Treatment
- Nadia Fairbairn (BC Centre on Substance Use, BC)
- Bernard Le Foll (CAMH, ON);
- Christy Sutherland (Portland Hotel Society, BC);
- Jeffrey Turnbull (Ottawa Inner City Health, ON);
- Karine Meador (Alberta Health Services, AB);
- Marie-Ève Goyer (University of Montréal, QC);
- Michel Perreault (McGill University, QC)

Connect and engage a national group of iOAT healthcare providers and service delivery leaders to create a virtual, online community with the goal of sharing success stories and challenges, sharing resources, and participating in educational activities.
To access the iOAT Community of Practice virtual platform, please contact Karen McCrae at karen.mccrae@bccsu.ubc.ca.
Objectives
The purpose of this thematic area is to facilitate and support the successful delivery of injectable opioid agonist treatment (iOAT) in Canada through educational resources, development of best practices and recommendations, and monitoring and evaluation.
National Clinical iOAT Guidelines
Key Recommendations
- Injectable opioid agonist treatment should be considered for people with severe opioid addiction who do not respond to oral treatments, as well as people who actively use illicit injectable opioids.
- Diacetylmorphine and hydromorphone, two injectable opioid agonist therapies, are recommended as options for patients likely to benefit from injectable opioid agonist treatment, with the decision of which treatment to use made based on availability, patient choice and the judgment of the prescriber.
- As assigning an end date to treatment is associated with a return to illicit opioid use, injectable opioid agonist treatments should be prescribed on an open-ended basis, and the decision to transition to another treatment should be made collaboratively with the patient.
Knowledge Transfer
- Nadia Fairbairn and Christy Sutherland were featured on a Canadian Medical Association Journal (CMAJ) podcast to discuss the iOAT National Clinical Guideline, which was published in CMAJ in September 2019.
Podcast | Injectable opioid agonist treatment for opioid use disorder
Article | Fairbairn, et al. 2019. Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline. Canadian Medical Association Journal 191(38): 1049-1056.
Environmental Scan
Two sequential environmental scans of iOAT programs were conducted from September to October 2018 and from March to May 2019, which included questions about location, service delivery model, clinical and operational characteristics, client demographics and numbers, and program barriers and facilitators.
Article | Eydt, et al. 2021. Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans. Canadian Medical Association Journal OPEN, 9(1): 115-124.
External Resources
Clinical Guideline for Prescribers
Addictions and Mental Health Ontario (AMHO)
AMHO received funding from Health Canada’s Substance Use and Addictions Program (SUAP) to lead a project on Planning for the Appropriate Use of Prescription Heroin.
This project aimed to assist provincial governments and health authorities in determining whether supervised iOAT programs should be expanded in Ontario for persons with severe opioid dependence. In addition, the project aimed to support the implementation of programs where appropriate by documenting system level processes, including training, and regulatory requirements that are necessary for successful implementation in Ontario and that reflect clinical and operational standards.
See more information about the project here.