Management of opioid use disorders: a national clinical practice guideline

Bruneau, Julie; Ahamad, Keith; Goyer, Marie-Ève; Poulin, Ginette; Selby, Peter; Fischer, Benedikt; Wild, T. Cameron; Wood, Evan

doi:10.1503/cmaj.170958

Cited by 311 publications

(387 citation statements)

References 88 publications

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“…The World Health Organization has developed guidelines to promote healthy housing standards to save lives, prevent disease and increase quality of life. 196 Other guidelines specific to opioid use disorder exist, 197,198 including 1 for "treatment-refractory" patients. 199 In the United Kingdom, the National Institute for Health Care and Excellence has published guidelines for outpatient treatment of schizophrenia and has published multimorbidity guidelines (www.nice.org.uk/guidance).…”

Section: Other Guidelinesmentioning

confidence: 99%

Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

Pottie

Kendall²,

Aubry³

et al. 2020

CMAJ

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H omeless and vulnerably housed populations are heterogeneous 1 and continue to grow in numbers in urban and rural settings as forces of urbanization collide with gentrification and austerity policies. 2 Collectively, they face dangerous living conditions and marginalization within health care systems. 3 However, providers can improve the health of people who are homeless or vulnerably housed, most powerfully by following evidence-based initial steps, and working with communities and adopting anti-oppressive practices. 1,4,5 Broadly speaking, "homelessness" encompasses all individuals without stable, permanent and acceptable housing, or lacking the immediate prospect, means and ability of acquiring it. 6 Under such conditions, individuals and families face intersecting social, mental and physical health risks that significantly increase morbidity and mortality. 7,8 For example, people who are homeless and vulnerably housed experience a significantly higher prevalence of trauma, mental health conditions and substance use disorders than the general population. 7,9 Canadian research reports that people who experience homelessness face life expectancies as low as 42 years for men and 52 years for women. 7 A generation ago, homeless Canadians were largely middleaged, single men in large urban settings. 10 Today, the epidemiology has shifted to include higher proportions of women, youth, Indigenous people (Box 1), immigrants, older adults and people from rural communities. 13,14 For example, family homelessness (and therefore homelessness among dependent children and youth) is a substantial, yet hidden, part of the crisis. 15 In 2014, of the estimated 235 000 homeless people in Canada, 27.3% were women, 18.7% were youth, 6% were recent immigrants or migrants, and a growing number were veterans and seniors. 10

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Section: Other Guidelinesmentioning

confidence: 99%

Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience

Pottie

Kendall²,

Aubry³

et al. 2020

CMAJ

View full text Add to dashboard Cite

show abstract

“…Buprenorphine-naloxone is effective in reducing illicit opioid use, but has a lower overdose risk and fewer adverse effects than methadone. 1 Both buprenorphine-naloxone and methadone treatments are associated with reduced all-cause mortality, and both are more effective than abstinencebased treatments. 2 Buprenorphine-naloxone is also safe to prescribe and initiate in pregnancy; 1,3 however, clinicians treating pregnant patients with opioid use disorder should consider consulting a specialist.…”

Section: Buprenorphine-naloxone Is First-line Therapy For Opioid Usementioning

confidence: 99%

“…2 Buprenorphine-naloxone is also safe to prescribe and initiate in pregnancy; 1,3 however, clinicians treating pregnant patients with opioid use disorder should consider consulting a specialist. 1,3 2 Buprenorphine-naloxone should be offered in all care settings,…”

Section: Buprenorphine-naloxone Is First-line Therapy For Opioid Usementioning

confidence: 99%

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Buprenorphine–naloxone

Nijmeh

Pyle

2018

CMAJ

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“…Due to the potential abuse of take home medication, including the potential danger of children and third parties with contact to opioid users, national and international guidelines recommend close monitoring of patients in OMT with take‐home prescription …”

Section: Introductionmentioning

confidence: 99%