Opioid Use Disorder (Opioid Addiction)

Care for People 16 Years of Age and Older

Click below to see a list of brief quality statements and scroll down for more information.

Quality Statements in Brief

Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.

Quality Statement 1: Identifying and Diagnosing Opioid Use Disorder
People at risk of opioid use disorder are asked about their opioid use and are further assessed as appropriate.

Quality Statement 2: Comprehensive Assessment and Collaborative Care Plan
People diagnosed with or identified as having opioid use disorder have a comprehensive assessment and a care plan developed in collaboration with their care providers.

Quality Statement 3: Addressing Physical Health, Mental Health, Additional Addiction Treatment Needs, and Social Needs
People with opioid use disorder have integrated, concurrent, culturally safe management of their physical health, mental health, additional addiction treatment needs, and social needs.

Quality Statement 4: Information to Participate in Care
People with opioid use disorder are provided with information to enable them to participate in their care. If their family is involved, they are also provided with this information.

Quality Statement 5: Opioid Agonist Therapy as First-Line Treatment
People with opioid use disorder are informed that treatment that includes opioid agonist therapy is safer and more effective than treatments that do not include opioid agonist therapy.

Quality Statement 6: Access to Opioid Agonist Therapy
People diagnosed with or identified as having opioid use disorder have access to opioid agonist therapy as soon as possible, within a maximum of 3 days.

Quality Statement 7: Treatment of Opioid Withdrawal Symptoms
People with opioid use disorder who are in moderate or severe withdrawal from opioids are offered relief of their symptoms with buprenorphine/naloxone within 2 hours.

Quality Statement 8: Access to Take-Home Naloxone and to Overdose Education
People with opioid use disorder and their families have immediate access to take-home naloxone and to overdose education.

Quality Statement 9: Tapering Off of Opioid Agonist Therapy
People who have achieved sustained stability on opioid agonist therapy who wish to taper off are supported in a collaborative slow taper if clinically appropriate.

Quality Statement 10: Concurrent Mental Health Disorders
People with opioid use disorder who also have a mental health disorder are offered concurrent treatment for their mental health disorder.

Quality Statement 11: Harm Reduction
People who use opioids have same-day access to harm reduction services. A comprehensive harm reduction approach includes education, safe supplies, infectious disease testing, vaccinations, appropriate referrals, and supervised consumption services.

Resources Quality Statements Advisory Committee About

11

Harm Reduction

People who use opioids have same-day access to harm reduction services. A comprehensive harm reduction approach includes education, safe supplies, infectious disease testing, vaccinations, appropriate referrals, and supervised consumption services.

Background

Harm reduction strategies are practices, programs, and policies that aim to reduce the adverse health, social, and economic consequences of substance use without requiring a person to abstain from substance use. Care providers and treatment programs for opioid use disorder should be guided by a harm reduction approach that enables immediate access to education and same-day access to harm reduction services as necessary.

What This Quality Statement Means

For People With Opioid Use Disorder

Your care provider may talk with you about harm reduction. Harm reduction strategies are ways to reduce your chances of getting an infection, having an overdose, or dying from using opioids. They include:

Information about how to be as safe as possible while taking opioids
Access to safe supplies, like sterile needles and alcohol swabs
Vaccinations for preventable illnesses like hepatitis B
Tests for infections like human immunodeficiency virus (HIV), hepatitis B, and hepatitis C
Referrals to other health care services you might want or need

Not everyone will want or need these services, but if you do, you should be able to get them the same day you ask for them.

For Care Providers

Offer all people who use opioids information on harm reduction. Offer people safe supplies if requested, or refer them to a location that provides safe supplies if they are not on hand. Where appropriate, encourage infectious disease testing and vaccinations. For those testing positive for infectious diseases, arrange timely referrals to appropriate medical care. For those likely to benefit from supervised consumption services, provide information on these services and offer to facilitate access to them.

For Health Services

Ensure systems, processes, and resources are in place to allow all people who use opioids immediate access to harm reduction education and same-day access to harm reduction services either on site or via referral.

Quality Indicators

Process Indicator

Percentage of people who use opioids who reported receiving harm reduction services within 24 hours of request

Denominator: total number of people who use opioids who requested harm reduction services
Numerator: number of people in the denominator who reported receiving harm reduction services within 24 hours
Data source: local data collection

Structural Indicator

Local availability of same-day access to harm reduction services

Data source: Ministry of Health and Long-Term Care

Definitions Used Within This Quality Statement

Education

Information gaps should be assessed, and, if needed, education should be offered to people with opioid use disorder on how to reduce the risk of the following:

Acquiring HIV, hepatitis B, hepatitis C, and other pathogens
Drug poisoning
Soft-tissue injuries
Other harms associated with drug consumption

Safe supplies

Safe supplies should be offered for the use of opioids and other substances, including the following: glass stems, screens, mouthpieces, push sticks, foil, meth pipes, needles and syringes, cookers, filters, ascorbic acid, sterile water, alcohol swabs, tourniquets, safe disposal containers, and condoms.

Infectious disease testing

The need for testing for infections should be assessed and, when appropriate, should be offered for HIV, hepatitis B, hepatitis C, sexually transmitted infections, and tuberculosis.

Vaccinations

The need for vaccinations should be assessed, and, when appropriate, vaccinations should be offered. Vaccinations to consider include those for diphtheria, hepatitis A, hepatitis B, influenza, pneumococcal pneumonia, and tetanus.

Appropriate referrals

Assess people for the need for referrals for human immunodeficiency virus (HIV) and hepatitis C treatment, other substance use concerns, and housing services.

Supervised consumption services

Supervised consumption services are spaces designated exempt from the Controlled Drugs and Substances Act. In these spaces, people can consume illicit drugs in a safe, supportive, hygienic environment under the supervision of staff who can intervene in the event of an overdose or other adverse event. Staff can also offer assessment and education and encourage engagement with or provide referrals to other health or treatment services.

Evidence to Improve Care