Journal
CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE
Volume 111, Issue 4, Pages 606-609Publisher
SPRINGER INTERNATIONAL PUBLISHING AG
DOI: 10.17269/s41997-020-00315-4
Keywords
Opiate substitution treatment; Heroin; Hydromorphone; Drug overdose
Categories
Funding
- St. Michael's Hospital Foundation
- Canadian Institutes of Health Research (CIHR) Vanier Canada Graduate Scholarship
- US National Institute on Drug Abuse Avenir Award [DP2-DA040256]
- CIHR, via a New Investigator Award
- Ontario Ministry of Research, Innovation and Science via an Early Researcher Award
Ask authors/readers for more resources
The increasing incidence of fatal opioid overdose is a public health crisis in Canada. While buprenorphine/naloxone and methadone are the standard first-line of opioid substitution options, limitations, including difficulty achieving long-term retention for some people who use opioids, are well known. For this group, injectable diacetylmorphine or hydromorphone can achieve positive outcomes, including high retention rates, reduced use of unregulated opioids, and reduced criminal activity. In May 2019, Health Canada announced changes to increase the accessibility of diacetylmorphine and hydromorphone, and in September 2019, the CIHR-funded Canadian Research Initiative in Substance Misuse released a national clinical guideline for diacetylmorphine and hydromorphone as additional frontline substitution options. While these developments present opportunities for scale-up, significant financial, structural, and practice barriers continue to impede access. This commentary explores the current state of policy and practice for diacetylmorphine and hydromorphone as opioid substitution options in Canada, outlines the rationale for rapid expansion of access, and highlights clinical and policy changes that must be undertaken or the death toll will continue to rise.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available