Addressing the opioid crisis through innovative treatment options and investments in frontline projects and research

New evidence-based treatments available for opioid use disorder

On May 1, Health Canada approved a new indication for injectable hydromorphone for use by qualified healthcare professionals as part of injectable opioid agonist therapy in adults with severe opioid use disorder. This is the first approval of injectable hydromorphone for this purpose in the world.

On April 25, the Minister of Health also added diacetylmorphine (prescription heroin) to the federal government’s List of Drugs for an Urgent Public Health Need, on the recommendation of Canada’s Chief Public Health Officer, Dr. Theresa Tam. This list enables qualified healthcare professionals access to drugs to address an urgent public health need that are authorized for sale in certain other countries, but not yet authorized in Canada. Diacetylmorphine can now be imported and supplied in any province or territory in Canada to address the opioid crisis.

Studies have shown that injectable hydromorphone and diacetylmorphine are important drugs that can help stabilize and support the health of some patients with severe opioid use disorder, including increased retention in treatment programs. Both of these drugs are used in substance use disorder treatment in other countries with recognized success. These drugs are both opioids and have a similar chemical composition, although injectable hydromorphone is twice as potent as diacetylmorphine.

Funding of $10.7 million for 33 new research, treatment, and harm reduction initiatives

Substance Use and Addictions Program – $6.6 million for seven projects

Through its Substance Use and Addictions Program, Health Canada is providing approximately $6.6 million to seven new projects. These projects will provide Ontario health professionals with resources and information needed for more effective and targeted interventions.

Association of Faculties of Medicine of Canada (AFMC)
AFMC will receive approximately $2 million over three years to develop a curriculum for future physicians in the diagnosis, treatment, and management of pain. Working in partnership with Canada’s 17 medical schools, the project will identify the required competencies; develop comprehensive and evidence-based curriculum modules; and evaluate the curriculum’s impact at the educational, practice, and system levels.

Community Addictions Peer Support Association (CAPSA)
CAPSA will receive approximately $1.2 million over three years to raise awareness and increase public dialogue about stigma and recovery through public education campaigns, peer support sessions, and training of recovery ambassadors to lead community engagement activities.

Paramedic Association of Canada (PAC)
PAC will receive approximately $1.2 million over three years to develop an accredited national standard for paramedics to address health promotion, prevention, harm reduction, and treatment. The national standard would provide guidance, and consistent and accurate information related to opioid addiction and overdose.

Centre for Addiction and Mental Health (CAMH)
CAMH will receive more than $330,000 over nine months to complete a feasibility review of the use of social impact bonds to improve access to treatment programs for opioid use disorder. The project will focus on forming partnerships, identifying key target groups, developing a plan to scale up the project, and establishing an evaluation approach.

Canadian Association of Schools of Nursing (CASN)
CASN will receive approximately $979,000 over four years to update educational materials for health care professionals. The project will target educators to better inform the next generation of Canadian nurses, pharmacists, and social workers, with a goal of reaching more than 82,000 students. Through this project, these professionals will enter the workforce much better prepared to address problematic substance use and the opioid crisis.

Addictions and Mental Health Ontario (AMHO)
AMHO will receive more than $514,000 over three years to provide information to provincial governments and health authorities to assist them in determining whether prescription heroin programs are the appropriate intervention for their jurisdictions and provide implementation resources.

Institute for Safe Medication Practices Canada (ISMPC)
ISMPC will receive more than $357,000 over three years to develop an intervention targeting community pharmacists to reduce the initial quantities of opioids offered through a prescription for acute pain. This aims to minimize the amounts of unused opioids in the home and reduce the associated risks for harm.

Harm Reduction Fund – $2.6 million for 11 projects

The Government is providing more than $2.6 million to support 11 initiatives in Ontario through the Public Health Agency of Canada’s Harm Reduction Fund. The initiatives will help control infectious diseases that can be associated with drug use, while also linking people to treatment and support services. The Harm Reduction Fund is investing $7 million annually to support projects across Canada to prevent and control infectious diseases that can be associated with drug use.

Street Health Community Nursing Foundation
Street Health Community Nursing Foundation will receive $103,314 for a project where people with lived experience will provide educational information regarding safer sex practices and hepatitis C virus (HCV) and HIV prevention strategies to people who use substances in southeast downtown Toronto.

Somerset West Community Health
Somerset West Community Health will receive $282,678 to build on its Harm Reduction Peer Worker Program, a collaboration with Ottawa Public Health and the Centretown and Carlington Community Health Centres. The project will focus on engaging and strengthening skills, competencies and abilities of individuals who use drugs to prevent HIV and HCV.

Norwest Community Health Centre
Norwest Community Health Centre will receive $281,360 to collaborate with people with lived experience to design a peer-led program to deliver frontline services, including access to harm reduction services and information sharing, for people who use drugs within the Thunder Bay area.

South Riverdale Community Health Centre
South Riverdale Community Health Centre will receive $242,364 to expand its mobile harm reduction supply delivery service to include a second satellite program, which will deliver harm reduction services through street-based outreach to underserved communities in the South Riverdale area of Toronto.

Wabano Centre for Aboriginal Health
Wabano Centre for Aboriginal Health will receive $299,015 for a trauma-informed approach providing alternative coping mechanisms and behaviours. Through direct service providers, it will help the community acquire information about health risks and seek opportunities to link people to health, social and cultural support services.

The Black Coalition for AIDS Prevention of Metropolitan Toronto 
The Black Coalition for AIDS Prevention of Metropolitan Toronto will receive $289,876 for supporting African Caribbean and Black queer and trans men who have sex with men in Toronto with HIV prevention practices by delivering a peer-based prevention and educational support program focusing on the distribution and promotion of resources and harm reduction supplies to this community. 

Réseau ACCESS Network
Réseau ACCESS Network will receive $233,142 to train individuals with current or past experience with using drugs to provide street outreach services to peers. These individuals will distribute materials pertaining to HIV and HCV, and make referrals to community partners and services, including HIV and HCV testing, treatment and support.

HIV/AIDS Regional Services
HIV/AIDS Regional Services will receive $262,662 to create a mobile outreach service to provide access to safer drug-use and harm reduction supplies, and onsite testing for HIV and HCV for people who use drugs in both rural and remote communities. It will also support capacity-building for youth on harm reduction within the context of sexually transmitted blood-borne infections. 

The AIDS Committee of York Region
The AIDS Committee of York Region has received $249,926 to build a harm reduction program for the nine municipalities located in the York Region of Ontario. The program engages people who use drugs to develop training for service providers to increase low-barrier access to community health and social services, reduce stigma and discrimination, and enhance health outcomes for people who use drugs.

Positive Living Niagara
Positive Living Niagara has received $269,769 to more than double the existing harm reduction peer outreach provided by the organization, by expanding outreach services to a higher number of contacts, including in-home visits through mobile outreach.

Kingston Community Health Centres
Kingston Community Health Centres has received $300,086 to update the current Best Practice Recommendations for Canadian harm reduction programs that provide service to people who use drugs and are at risk for HIV, HCV, and other harms, and develop resources and supports to build the capacity of frontline staff working at harm reduction agencies.

Canadian Institutes of Health Research – $1.5 million for 15 grants
The Government of Canada recognizes that evidence-based treatment is key to responding to the opioid crisis. Through the Canadian Institutes of Health Research, nearly $1.5 million is being invested in 15 evaluation grants to rapidly assess interventions and practices that have been put in place to address the most urgent elements of the opioid crisis.