Manitoba Opioid Agonist Therapy Recommended Practice Manual
CPSM convened a working group of experts in the treatment of opioid use disorder in the spring of 2019. This working group was tasked with assisting CPSM staff in developing a new Recommended Practice Manual for the use of buprenorphine-containing formulations in the context of Opioid Agonist Therapy in Manitoba. CPSM receives frequent requests for guidance on the issues the working group is discussing. The working group thus elected to publish its recommendations on this page, as individual sections, as they are completed.
During the winter of 2021, the same working group was tasked with updating CPSM’s 2014 publication titled ‘Manitoba Methadone and Buprenorphine Maintenance Recommended Practice’. This publication included minimal guidance on buprenorphine-containing OAT formulations. The methadone guidance had also become outdated and in need of revision. This work is ongoing, along with the completion of the buprenorphine-specific sections. Completed methadone-specific guidance is published on this page, along with the buprenorphine-specific guidance documents. Combined, these written sections will eventually form part of the new and up-to-date Manitoba Opioid Agonist Therapy Recommended Practice Manual. This manual will be distributed in printed format, once complete. A living version of the manual will also be hosted on this webpage to facilitate periodic updates over time.
Physicians are encouraged to adopt and incorporate these recommendations into their Opioid Agonist Therapy practices without delay. Should members have any questions about the interpretation of the guidance published in the documents below, please do not hesitate to contact the chair of the working group at CPSM, Dr. Marina Reinecke. It is the working group’s hope that you will find this guidance useful in providing care to your patients on opioid agonist therapy.
- Introduction: Application, Training, & Regulatory Requirements to Provide OAT
- Initiating OAT: Comprehensive Assessment, Diagnosis, Informed Consent & Investigations
- Managing Polypharmacy, Benzodiazepines, Alcohol, & Polysubstance Use in OAT
- In-Hospital Care Section
- Managing Acute, Chronic, and Perioperative Pain in OAT
- HIV & Hepatitis C in the Patient with OUD - Prevention, Screening, & Management
- Buprenorphine/naloxone Take-home (Carry) Dosing Recommendations
- Unwitnessed Induction Section
- Recommendations for Buprenorphine Micro-dosing Inductions
- Sublocade: Considerations in Informed Consent & Resources
- Introduction: The Pharmacology of Methadone & Management of Adverse Effects
- Recommendations for Methadone Induction, Titration, and Stabilization for OUD
Alternative Treatment Guidance (including SROM)
- Consent Form to Participate in Treatment with Sublocade: General
- Consent Form to Participate in Treatment with Sublocade: Reproductive Age
- Emotions, Anxiety, and Addiction - patient handout