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A new Canadian guideline for managing opioid use disorders

New national guideline, published in Canadian Medical Association Journal (CMAJ), sets out best practices for treating opioid addiction..

A new Canadian guideline for managing opioid use disorders lays out the optimal strategies for the treatment of opioid addiction, including recommending opioid agonist treatment with buprenorphine-naloxone as the preferred first-line treatment. The guideline, published in CMAJ (Canadian Medical Association Journal), was created for a wide range of health care providers to address an urgent need for evidence-based treatment of opioid use causing overdoses and death.

"Opioid use disorder is a public health emergency nationwide and this guideline provides a blueprint for health practitioners to step up and provide evidence-based care," says Dr. Julie Bruneau lead author of the pan-Canadian guideline group and a physician at the Centre hospitalier de l'Université de Montréal.

Like the U.S., Canada faces a growing opioid crisis, with opioid-related fatalities totaling 2,861 in 2016, according to the authors. Therefore, an expert panel of professionals from the Canadian Institutes of Health Research’s Canadian Research Initiative in Substance Misuse network developed new clinical practice guidelines to provide health care professionals with the evidence-based tools and strategies to manage and treat patients with opioid use disorders in Canada.

The panel recommends:

  • buprenorphine-naloxone as the first-line treatment for opioid use disorders;
  • avoiding withdrawal management alone;
  • a stepped and integrated care approach.


Julie Bruneau, Keith Ahamad, Marie-Ève Goyer, Ginette Poulin, Peter Selby, Benedikt Fischer, T. Cameron Wild, Evan Wood. Management of opioid use disorders: a national clinical practice guideline. Canadian Medical Association Journal, 2018; 190 (9): E247Download
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