Guidelines for Opioid Addiction Treatment

In April 2016, B.C.’s provincial health officer declared a public health emergency in response to the rapid rise in drug overdoses and overdose deaths in B.C. The BC Centre on Substance Use and the Ministry of Health have developed provincial guidelines for the treatment of opioid addiction. These guidelines include information on pharmacotherapy and the management of withdrawal related to the treatment of opioid use disorder. Two key points from these guidelines are:

1. Withdrawal management (i.e. detox) as standalone approach is not recommended, as this approach has been associated with increased risk of HIV and hepatitis C transmission, elevated rates of overdose deaths in comparison to providing no treatment, and nearly universal relapse when implemented without plans to transition to long-term evidence-based addiction treatment. 
2. The guidelines strongly recommend buprenorphine/naloxone (Suboxone®) as the preferred first-line treatment for opioid use disorder, when feasible, given its safety profile. Other treatment options, including methadone, should be used when buprenorphine/naloxone is contraindicated or not feasible, or if buprenorphine/naloxone has been tried and is not effective.

Read the full British Columbia Centre on Substance Use guidelines on the clinical management of opioid use disorder.

For more information about clinical guidance around opioid use disorder see Clincal Care Guidance on the BC Centre for Substance Use website.

• A Guideline for the Clinical Management of Opioid Use Disorder: This guideline is intended for use for all B.C. physicians, nursing and allied health professionals, and other care providers involved in the treatment of individuals with opioid use disorder. 
• Take Home Naloxone/Toward The Heart: The BC Take Home Naloxone (THN) program is provided in collaboration with BC Centre for Disease Control, regional health authorities and other community stakeholders. The program provides training and naloxone kits free of change to people who are at risk of an opioid overdose and those likely to witness an overdose (including friends and family members of those at risk of overdose). On this website you can find nearby harm reduction sites and the closest ‘Take Home Naloxone’ distribution site.
• Canadian Best Practices for Harm Reduction Programs: These guidelines contain recommendations about best practice for Canadian harm reduction programs, which aim to reduce HIV and HCV transmission, overdose risk, and other harms associated with substance use. 
• Safety Bulletin: Avoid the use of withdrawal management as a standalone treatment for opioid use disorder