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Evidence to Improve Care

Opioid Use Disorder (Opioid Addiction)

Care for People 16 Years of Age and Older

Click below to see a list of brief quality statements and scroll down for more information.

Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.

Quality Statement 1: Identifying and Diagnosing Opioid Use Disorder
People at risk of opioid use disorder are asked about their opioid use and are further assessed as appropriate.

Quality Statement 2: Comprehensive Assessment and Collaborative Care Plan
People diagnosed with or identified as having opioid use disorder have a comprehensive assessment and a care plan developed in collaboration with their care providers.

Quality Statement 3: Addressing Physical Health, Mental Health, Additional Addiction Treatment Needs, and Social Needs
People with opioid use disorder have integrated, concurrent, culturally safe management of their physical health, mental health, additional addiction treatment needs, and social needs.

Quality Statement 4: Information to Participate in Care
People with opioid use disorder are provided with information to enable them to participate in their care. If their family is involved, they are also provided with this information.

Quality Statement 5: Opioid Agonist Therapy as First-Line Treatment
People with opioid use disorder are informed that treatment that includes opioid agonist therapy is safer and more effective than treatments that do not include opioid agonist therapy.

Quality Statement 6: Access to Opioid Agonist Therapy
People diagnosed with or identified as having opioid use disorder have access to opioid agonist therapy as soon as possible, within a maximum of 3 days.

Quality Statement 7: Treatment of Opioid Withdrawal Symptoms
People with opioid use disorder who are in moderate or severe withdrawal from opioids are offered relief of their symptoms with buprenorphine/naloxone within 2 hours.

Quality Statement 8: Access to Take-Home Naloxone and to Overdose Education
People with opioid use disorder and their families have immediate access to take-home naloxone and to overdose education.

Quality Statement 9: Tapering Off of Opioid Agonist Therapy
People who have achieved sustained stability on opioid agonist therapy who wish to taper off are supported in a collaborative slow taper if clinically appropriate.

Quality Statement 10: Concurrent Mental Health Disorders
People with opioid use disorder who also have a mental health disorder are offered concurrent treatment for their mental health disorder.

Quality Statement 11: Harm Reduction
People who use opioids have same-day access to harm reduction services. A comprehensive harm reduction approach includes education, safe supplies, infectious disease testing, vaccinations, appropriate referrals, and supervised consumption services.

Emerging Practice Statement: Pharmacological Treatment Options for People With Opioid Use Disorder and Treatment Options for Adolescents

An emerging practice statement describes an area for quality improvement that has been prioritized by the advisory committee but for which there is insufficient or inconsistent evidence in the guidelines used in the development of the quality statements. An emerging practice statement acknowledges that there is a need for evidence-based guidance to be developed in an area but that the evidence base in this area is still emerging.

Additional Opioid Agonist Therapy Options

For people with opioid use disorder who have been offered traditional opioid agonist therapy (both buprenorphine/naloxone and methadone) and had suboptimal results, or who do not wish to take these treatments, there may be added value in considering other opioids within the context of a harm reduction framework. This could include prescribed oral opioids, prescribed injection opioids, or supervised consumption of non-prescription opioids.

Opioid Antagonist Therapy

For people with opioid use disorder who are no longer taking opioids (including opioid agonist therapy), opioid antagonists such as naltrexone may assist in preventing relapse to opioid use. Novel delivery systems, including extended-release formulations and long-acting implants, show more promise than the oral naltrexone currently available in Canada.

Treatment Options for People Under 16 Years of Age

The guidelines used to develop this quality standard were based on studies conducted with adult populations. This quality standard may be of benefit to adolescents with moderate or severe opioid use disorder, but there is insufficient evidence to be sure what high-quality care looks like for this age group.


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