Recommendations summary*
| Category | Recommendation | Quality of evidence | Strength of recommendation |
|---|---|---|---|
| Injectable opioid agonist treatment | Injectable opioid agonist treatment should be considered for individuals with severe, treatment-refractory opioid use disorder and ongoing illicit injection opioid use. | Moderate | Conditional |
| Medication selection | For patients who are determined to be likely to benefit from injectable opioid agonist treatment, both diacetylmorphine and hydromorphone are acceptable treatment options. | Low | Strong |
| Treatment end date | Injectable opioid agonist treatment should be provided as an open-ended treatment, with decisions to transition to oral opioid agonist treatment made collaboratively with the patient. | Low | Strong |
↵* Protocols and other clinical guidance can be found in the full guideline in Appendix 1. The 3 key recommendations were formulated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and are based on the existing literature on injectable opioid agonist treatment, including 2 systematic reviews and meta-analyses.