Theme: Models of Care Year: 2022
Background:
Two research projects carried out in Québec have led to the formulation of 10 proposals to consider
when addressing practice improvement related to the management of people who use opioids, and
more specifically practices related to opioid use disorder (OUD) treatment. These were developed
with the goal of providing a continuum of services that are in line with the multiple experiences of
people who use opioids.
Description of model of care/intervention:
One proposal concerns the implementation of minimal and extensive service baskets in the teams
providing OUD treatment in Québec. OUD treatment is based on the prescription of an opioid agonist
therapy (OAT) and a complementary offer of services, delivered on an ongoing basis and according to
the vulnerability of the person’s situation. To this end, the teams that accompany patients in OAT
should systematically offer a minimal basket of services aimed primarily at reducing the harms
associated with drug use (e.g., management of polydrug use, mental health care), in a single location
(one stop shop). An extensive basket of services should also be available for people with more complex
needs (e.g., HCV and HIV treatment; primary health care).
Effectiveness:
The research projects results led the ministère de la Santé et des Services sociaux du Québec to modify
its service offer to include the minimal basket. Its implementation in all teams providing OUD
treatment in Quebec is now identified as a priority in the framework of the Canada-Québec Emergency
Treatment Fund for the Opioid Crisis.
Conclusion and next steps:
Identifying the minimal and optimal services that should be offered to people with OUD has the
potential to improve the continuum of care and better meet their needs. The implementation of
service baskets will establish a standard of care for OUD treatment in Québec, but much work remains
to ensure that these services are implemented.
Disclosure of Interest Statement:
The work conducted by L’Équipe de soutien clinique et organisationnel en dépendance et itinérance
(ESCODI) is funded by the L’Institut universitaire sur les dépendances (IUD) through the Direction des
services en dépendance et itinérance du ministère de la Santé et des Services sociaux du Québec and
by Health Canada’s Substance Use and Addictions Program (SUAP).