New Practice Alert: Injectable Opioid Agonist Treatment for patients with Opioid Use Disorder

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What do I need to know?

Injectable Opioid Agonist Treatment (iOAT) is part of the continuum of care for individuals with opioid use disorder (OUD) who inject opioids. iOAT is for those who have not adequately benefited from or have declined oral OAT like methadone, buprenorphine, or slow-release oral morphine. 

Why use iOAT over other forms of OAT?

  • iOAT has higher retention in care than methadone for treatment refractory patients. 
  • iOAT can be administered concurrently with other opioid medications, including oral OAT, prescribed alternatives, and acute pain management. 

What’s New: 

Island Health now offers diamorphine (Diacetylmorphine or “DAM”) and HYDROmorphone (Dilaudid or “HM”) iOAT continuation in hospital settings for patients who are receiving iOAT in community. DAM and HM are approved by Health Canada as evidence-based treatment options for individuals diagnosed with moderate to severe OUD and are prescribed under the guidance of an Addiction Medicine prescriber.

In hospital, iOAT is prescribed by physicians with Addiction Medicine expertise, including Addiction Medicine Consult Service (AMCS). If AMCS is not available, iOAT can be continued by MRP with direct consultation with AMCS, AVI SAFER prescriber, RACE line.

What do I need to do?                                     

Registered Nurses do not require formal education to administer iOAT in hospital settings. If providing care to an iOAT patient, please ensure your team is following the guidance in the practice support resources detailed below. 

A workflow for inpatient psychiatric units caring for iOAT patients will soon be shared with those units. 

Practice Support Resources for Nurses:

The iOAT staff intranet ​has all practice supports related to iOAT, including: 

Immediate Support Contacts

Additional Non-Urgent Support or to provide feedback on iOAT practice resources: