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Guideline

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

Nadia Fairbairn, Josey Ross, Michael Trew, Karine Meador, Jeff Turnbull, Scott MacDonald, Eugenia Oviedo-Joekes, Bernard Le Foll, Marie-Ève Goyer, Michel Perreault and Christy Sutherland
CMAJ September 23, 2019 191 (38) E1049-E1056; DOI: https://doi.org/10.1503/cmaj.190344
Nadia Fairbairn
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Josey Ross
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Michael Trew
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Karine Meador
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Jeff Turnbull
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Scott MacDonald
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Eugenia Oviedo-Joekes
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Bernard Le Foll
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Marie-Ève Goyer
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Michel Perreault
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Christy Sutherland
Department of Medicine (Fairbairn, Sutherland), University of British Columbia; British Columbia Centre on Substance Use (Fairbairn, Ross, Sutherland), Vancouver, BC; Department of Psychiatry, Faculty of Medicine (Trew), University of Calgary; Alberta Health Services (Trew), Calgary, Alta.; Inner City Health and Wellness Program and Addiction Recovery and Community Health (Meador), Royal Alexandra Hospital, Edmonton, Alta.; Ottawa Inner City Health (Turnbull), Ottawa, Ont.; Providence Crosstown Clinic (MacDonald); School of Population and Public Health (Oviedo-Joekes), University of British Columbia; Centre for Health Evaluation & Outcome Sciences (Oviedo-Joekes), Providence Health Care, Vancouver, BC; Translational Addiction Research Laboratory (Le Foll), Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry (Le Foll), Institute of Medical Science, University of Toronto, Toronto, Ont.; Département de médicine de famille et de médicine d’urgence (Goyer), Faculté de médicine, Université de Montréal; Centre de recherche et d’aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sudde-I’Île-de-Montréal; Department of Psychiatry (Perreault), McGill University; Douglas Mental Health Institute (Perreault), Montréal, Que.; PHS Community Services Society (Sutherland), Vancouver, BC
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Canadian Medical Association Journal: 191 (38)
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Vol. 191, Issue 38
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Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline
Nadia Fairbairn, Josey Ross, Michael Trew, Karine Meador, Jeff Turnbull, Scott MacDonald, Eugenia Oviedo-Joekes, Bernard Le Foll, Marie-Ève Goyer, Michel Perreault, Christy Sutherland
CMAJ Sep 2019, 191 (38) E1049-E1056; DOI: 10.1503/cmaj.190344

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Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline
Nadia Fairbairn, Josey Ross, Michael Trew, Karine Meador, Jeff Turnbull, Scott MacDonald, Eugenia Oviedo-Joekes, Bernard Le Foll, Marie-Ève Goyer, Michel Perreault, Christy Sutherland
CMAJ Sep 2019, 191 (38) E1049-E1056; DOI: 10.1503/cmaj.190344
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