Expanding Opioid Substitution Treatment with Managed Opioid Programs

Methadone and Suboxone are the most commonly offered opioid substitution treatments. These need to be expanded to include managed opioid programs which provide patients with oral or injectable hydromorphone or diacetylmorphine (pharmaceutical heroin) under medical supervision. Managed opioid programs are evidence-based programs that have been shown to increase retention in treatment, reduce the use of street drugs, and decrease crime. The Province of Ontario recently announced a $102 million funding agreement with the federal government for drug treatment. In the context of the current opioid poisoning crisis, the Ministry of Health and Long-Term Care should target some of this funding to rapidly scale up the implementation of managed opioid programs in Toronto and elsewhere in Ontario to help save lives and improve health outcomes for people who use drugs.

And further, to take the necessary steps to add these medications at the appropriate concentrations to the Ontario Drug Benefit Formulary for the treatment of opioid use disorder; c. Seek authority from Health Canada to import diacetylmorphine (pharmaceutical heroin) for use as a managed opioid program medication in Ontario; d. Work with Health Canada and other necessary federal bodies to address barriers to procuring, storing, and transporting diacetylmorphine (pharmaceutical heroin) and/or mitigate their effects to facilitate the use of this managed opioid program medication; and e. Ensure that managed opioid medications are universally accessible to all Ontarians who could benefit from these kinds of programs, and that cost is not a barrier.