Injectable opioid agonist treatment (iOAT) is becoming more available in Canada as an evidence-based option within the opioid use disorder continuum of care. iOAT in Canada currently involves the supervised injection of prescribed hydromorphone, or diacetylmorphine (i.e. medical heroin). Little is known about the availability of iOAT in Canada, or the ways in which it is being delivered. This five-year environmental scan series was undertaken to support national expansion occurring as part of the opioid overdose response, and to address ongoing gaps in care. Surveys with contacts at each participating iOAT program across the country involve baseline and 6-month follow-up surveys in year one, and annual follow-up surveys in years 2-5.

Details about experiences with iOAT in BC are available on our iOAT Study page.


  1. To map out and describe iOAT, tablet iOAT, and safer supply programs and their service delivery models in Canada
  2. To identify service delivery gaps in areas of the country most affected by the overdose crisis
  3. To summarize learning about the implementation and delivery of iOAT, tablet iOAT, and safer supply programs to inform policy and practice


Mapping out access to iOAT, tablet iOAT, and safer supply in Canada, including programs’ capacity, waitlists, hours of service, and regional coverage, provides a starting point for identifying unmet needs. Insights into service delivery models and program features, such as location, types of clients, staffing composition and levels, medication type, dose schedules, and access to other health and social supports, can inform the design of emerging programs. Lessons learned from the implementation and operation of existing sites can support the effective and efficient scale-up of iOAT, tablet iOAT, and safer supply programs to meet the needs of Canadians in more areas of the country.


This project represents a partnership within the Canadian Research Initiative in Substance Misuse (CRISM) Network. Direct contributors from the CRISM iOAT EHT Steering Committee include:

  • Dr. Nadia Fairbairn (Principal Investigator)
  • Dr. Christy Sutherland
  • Dr. Karine Meador
  • Dr. Michael Trew
  • Dr. Michel Perreault
  • Dr. Marie-Eve Goyer
  • Dr. Bernard Le Foll
  • Dr. Jeffrey Turnbull

Project coordinators: Karen McCrae & Dr. Stephanie Glegg

We would also like to thank the nominated contacts at each participating site for their support in gathering the data.


  • Canadian Institutes of Health Research (CIHR) EHT grant awarded to CRISM
  • Michael Smith Foundation for Health Research/St. Paul’s Foundation Scholar Award
  • CIHR Fellowship Award


More information about iOAT, the CRISM National iOAT Community of Practice, and National iOAT clinical and operational guidelines can be found here.

For more information about this research, please contact Karen McCrae, Environmental Scan Coordinator, at [email protected]

BC Centre on Substance Use

400-1045 Howe St, Vancouver, BC V6Z 2A9

E: [email protected] | T: (778) 945-7616 | F: (604) 428-5183

24/7 Addiction Clinician Support Line: (778) 945-7619

Online Addiction Medicine Diploma: [email protected].

website logos footer

Copyright © 2023, BC Centre on Substance Use