Proposals for the improvement of opioid agonist treatment in Quebec
Introduction: The actual opioid crisis highlights the need to invest in and promote best practices for people with opioid use disorder. This article aims to present results of a participative approach used in two research projects aimed at identifying the characteristics of low threshold programs and the best practices in the medical management of opioid withdrawal. The two projects ultimately share the objective of improving treatment for people with opioid use disorder and access to these services. Methods: The two projects relied on two narrative reviews whose objectives were to identify best practices regarding low threshold services for people with opioid use disorder and the medical management of opioid withdrawal. Individual and group interviews were conducted with clinicians, community workers and people using opioids in different regions of Quebec in order to assess the state of practices in low-threshold services and in medical management of opioid withdrawal. Results: The results of these two projects led to the publishing of ten proposals for the improvement of services for people with opioid use disorder in Quebec. These proposals relate to the intervention’s philosophy, peer inclusion, and the continuum of care for people with opioid use disorder. These proposals have implications for clinical teams, administrators and stakeholders involved in services provision to people with opioid use disorder. Conclusion: Throughout the process, the participative approach described in this article led to improvements in the way services are offered to people with opioid use disorder in Quebec. Ultimately, the improvement of the care for people who use opioids, involves the development of formation and training for healthcare professionals, the update of clinical guidelines regarding treatment of opioid use disorder, and the development of services to support healthcare professionals implementing those proposals.