Table 1:

Recommendations summary*

CategoryRecommendationQuality of evidenceStrength of recommendation
Injectable opioid agonist treatmentInjectable opioid agonist treatment should be considered for individuals with severe, treatment-refractory opioid use disorder and ongoing illicit injection opioid use.ModerateConditional
Medication selectionFor patients who are determined to be likely to benefit from injectable opioid agonist treatment, both diacetylmorphine and hydromorphone are acceptable treatment options.LowStrong
Treatment end dateInjectable 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.LowStrong
  • * 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.