Safety profile of injectable hydromorphone and diacetylmorphine for long-term severe opioid use disorder

Cost‐effectiveness of hydromorphone for severe opioid use disorder: findings from the SALOME randomized clinical trial

“…potential for diversion, safety, undermining of other therapies, etc.) have been addressed by several randomized controlled trials and years of practice , policymakers remain reluctant to support its implementation or expansion. Much of that resistance stems from beliefs that the goal of any treatment should be abstinence of all opioids and from the stigma associated with opioid use disorder and related concerns about how public funds are allocated .…”

Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline

“…14 Although diacetylmorphine has substantially more evidence supporting its efficacy in treating opioid use disorder, it may pose an increased risk of adverse events (e.g., histamine reactions, seizures and overdose) compared with injectable hydromorphone. 14,27 Hydromorphone was associated with a significantly lower risk of both adverse events (0.60, 95% CI 0.39 to 0.90) and serious adverse events (0.21, 95% CI 0.06 to 0.69) compared with diacetylmorphine. 14 For these reasons, either medication can be considered a reasonable choice, based on availability, patient choice and prescriber judgment.…”

Evidence on the Effectiveness of Heroin-Assisted Treatment

“…Our literature search identified five additional articles evaluating the individual-level impacts of HAT based on the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) (Nikoo et al, 2018;Oviedo-Joekes et al, 2017a;Oviedo-Joekes et al, 2016;Oviedo-Joekes et al, 2017b;Palis et al, 2017), a more recent HAT RCT which did not have published results until after the most recent systematic review.…”