Clinical Resources for Opioid Use Disorder

Despite significant advancements in the province’s system of substance use care, drug poisoning involving opioids continues to be the leading cause of unnatural death in British Columbia, surpassing homicides, suicides, and motor vehicle collisions combined. The primary driver of this ongoing crisis is the rapidly growing toxicity and unpredictability of illegally manufactured and distributed drugs. Higher fentanyl concentrations and novel, dangerous combinations of drugs (e.g., benzodiazepines and fentanyl) have been continually detected in multiple drug surveillance data sources across the province.

This website intends to provide resources for all BC physicians, nursing and allied health professionals, and other care providers involved in the treatment of individuals with opioid use disorder.

Education and training to further support implementation of these and other evidence-informed clinical resources can be found here.

A Guideline for the Clinical Management of Opioid Use Disorder (2023)

In response to the escalating drug toxicity crisis, which was also exacerbated by the COVID-19 pandemic, evidence and clinical experience have continued to develop, necessitating updated clinical guidance.

The second edition of the Guideline for the Clinical Management of Opioid Use Disorder, published in November 2023, is intended to reflect this evolution and ensure that health care providers have access to updated clinical guidance aligned with the best available evidence on interventions across the continuum of opioid use disorder care. Accordingly, this updated guideline edition includes information on oral and injectable opioid agonist treatment, antagonist pharmacotherapies, withdrawal management strategies, psychosocial interventions including bed-based treatment programs, harm reduction services and programs, and peer-based support.

BC's Clinical Guideline for Treating Opioid Use Disorder (PDF)
Interactive Resources (phone-friendly app)
Webinar Series: Update to BC's Clinical Guidelines for Treating Opioid Use Disorder

In July 2024, BC’s Provincial Health Officer issued an order to end the public-health emergency for COVID-19 and rescinding all related orders. This includes the interim clinical guidance Risk Mitigation Guidance in the context of Dual Health Emergencies (RMG).

The sunsetting of RMG does not impact prescribing of pharmaceutical alternatives to the unregulated drug supply. Clinical resources for prescribed alternatives include the Opioid Use Disorder Practice Update (2022), Stimulant Use Disorder Practice Update (2022), and fentanyl-related protocols (2023). These resources provide guidance for clinicians considering prescribed alternatives for individuals assessed as being at high risk of toxic drug poisoning.

February 19, 2025: The Province of BC has announced changes to the prescribed alternatives policy, which will now require all prescribed alternatives to be witnessed by health professionals. This requirement goes into effect immediately for all new clients only. This supersedes the guidance previously published by the BCCSU, including the Opioid Use Disorder Practice Update.

The BCCSU will work with provincial regulatory colleges to develop clinical resources to support the safe transition of existing clients from non-witnessed to witnessed doses.

Note: This provincial policy change DOES NOT apply to OAT.

BC Centre on Substance Use

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