Expanding access to diacetylmorphine and hydromorphone for people who use opioids in Canada
| العنوان: | Expanding access to diacetylmorphine and hydromorphone for people who use opioids in Canada |
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| المؤلفون: | Nazlee Maghsoudi, Dan Werb, Jeanette M. Bowles |
| المصدر: | Can J Public Health |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Canada, medicine.medical_specialty, 030508 substance abuse, Drug overdose, Health Services Accessibility, Heroin, 03 medical and health sciences, 0302 clinical medicine, Naloxone, medicine, Humans, Hydromorphone, 030212 general & internal medicine, Intensive care medicine, business.industry, Public Health, Environmental and Occupational Health, Diacetylmorphine, Opioid overdose, General Medicine, medicine.disease, 3. Good health, Analgesics, Opioid, Opiate Overdose, Commentary, 0305 other medical science, business, medicine.drug, Methadone, Buprenorphine |
| الوصف: | The increasing incidence of fatal opioid overdose is a public health crisis in Canada. While buprenorphine/naloxone and methadone are the standard first-line of opioid substitution options, limitations, including difficulty achieving long-term retention for some people who use opioids, are well known. For this group, injectable diacetylmorphine or hydromorphone can achieve positive outcomes, including high retention rates, reduced use of unregulated opioids, and reduced criminal activity. In May 2019, Health Canada announced changes to increase the accessibility of diacetylmorphine and hydromorphone, and in September 2019, the CIHR-funded Canadian Research Initiative in Substance Misuse released a national clinical guideline for diacetylmorphine and hydromorphone as additional frontline substitution options. While these developments present opportunities for scale-up, significant financial, structural, and practice barriers continue to impede access. This commentary explores the current state of policy and practice for diacetylmorphine and hydromorphone as opioid substitution options in Canada, outlines the rationale for rapid expansion of access, and highlights clinical and policy changes that must be undertaken or the death toll will continue to rise. |
| تدمد: | 1920-7476 0008-4263 |
| DOI: | 10.17269/s41997-020-00315-4 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::22c4d4fea261109a9a141647fdaa25c3 https://doi.org/10.17269/s41997-020-00315-4 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....22c4d4fea261109a9a141647fdaa25c3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19207476 00084263 |
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| DOI: | 10.17269/s41997-020-00315-4 |