ArticleCMAJ open
Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Safer opioid supply clients' values and preferences: a systematic review and thematic synthesis of qualitative research.BMJ mental health · 2025Pooled it
- Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review.Harm reduction journal · 2022Pooled it
- Pharmacological Management of Opioid Use Disorder: A Systematic Review and Network Meta-Analysis: Prise en charge pharmacologique du trouble de l'usage des opiacés : revue systématique et méta-analyse en réseau.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Review
- Social justice with harm reduction approaches for mothers who use opioids: an international comparative ethnographic study with community engaged methods.Harm reduction journal · 2025Article
- Clinicians' Perspectives and an Ethical Analysis of Safer Supply Opioid Prescribing.Journal of bioethical inquiry · 2025Article
- "From an HCV and HIV point of view, it's been remarkable": A qualitative study about using prescribed safer supply to support people who use drugs along the HIV and HCV prevention and treatment cascades in Ontario, Canada.Journal of the International AIDS Society · 2025Article
- Barriers and facilitators to injectable opioid agonist treatment engagement within a structural vulnerability context: a qualitative study of patient experiences in Vancouver, Canada.Harm reduction journal · 2025Article
- Challenges for the implementation of injectable opioid agonist treatment: a scoping review.Harm reduction journal · 2024Article
- "I'm just searching to get better": Constructions of treatment citizenship on injectable opioid agonist treatment.Social science & medicine (1982) · 2024Article
- Shared decision-making and client-reported dose satisfaction in a longitudinal cohort receiving injectable opioid agonist treatment (iOAT).Substance abuse treatment, prevention, and policy · 2024Article
- "It feels like I'm coming to a friend's house": an interpretive descriptive study of an integrated care site offering iOAT (Dr. Peter Centre).Addiction science & clinical practice · 2023Article
- A Case report of a continuous ambulatory drug delivery (CADD) pump to deliver opioid agonist treatment in an acute care setting.Harm reduction journal · 2023Article
- Women's experiences in injectable opioid agonist treatment programs in Vancouver, Canada.The International journal on drug policy · 2023Article
- Access to tablet injectable opioid agonist therapy in rural and smaller urban settings in British Columbia, Canada: a qualitative study.Substance abuse treatment, prevention, and policy · 2023Article
- Clinical outcomes and health care costs among people entering a safer opioid supply program in Ontario.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Article
- "COVID just kind of opened a can of whoop-ass": The rapid growth of safer supply prescribing during the pandemic documented through an environmental scan of addiction and harm reduction services in Canada.The International journal on drug policy · 2022Article
- The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19.Harm reduction journal · 2022Article
- Feasibility of Testing Client Preferences for Accessing Injectable Opioid Agonist Treatment (iOAT): A Pilot Study.Patient preference and adherence · 2022Article
- Outcomes of Ottawa, Canada's Managed Opioid Program (MOP) where supervised injectable hydromorphone was paired with assisted housing.The International journal on drug policy · 2021Article
- Motivations to initiate injectable hydromorphone and diacetylmorphine treatment: A qualitative study of patient experiences in Vancouver, Canada.The International journal on drug policy · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundInjectable opioid agonist treatment (iOAT) is an emerging evidence-based option in the continuum of care for opioid use disorder in parts of Canada. Our study objective was to identify and describe iOAT programs operating during the ongoing opioid overdose crisis.
methodsWe conducted 2 sequential environmental scans. Programs were eligible to participate if they were in operation as of Sept. 1, 2018, and Mar. 1, 2019. Information was collected over 2-3 months for each scan (September-October 2018, March-May 2019). Programs that participated in the first scan and newly established programs were invited to participate in the second scan. The scans included questions about location, service delivery model, clinical and operational characteristics, numbers and demographic characteristics of clients, and program barriers and facilitators. Descriptive analysis was performed.
resultsWe identified 14 unique programs across the 2 scans. Eleven programs located in urban centres in British Columbia and Ontario participated in the first scan. At the time of the second scan, 2 of these programs were on hold and 2 of 3 newly established programs were in Alberta. The total capacity of all participating programs was 420 clients at most. Four service delivery models were identified; iOAT was most commonly integrated within existing health and social services. All programs offered hydromorphone, and 1 program also offered diacetylmorphine. In the first scan, 73% of clients (133/183) were male; the mean age of clients was 47 years. Limited capacity, pharmacy operations and lack of diacetylmorphine access were among the most frequently reported barriers. The most commonly reported facilitators included client-centred care, client relationships and access to other health and social support.
interpretationEvidence indicates that iOAT can be successfully implemented using diverse service delivery models. Future work should facilitate scale-up of this evidence-based treatment where gaps persist in high-risk communities.
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