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Health Quality Ontario’s Opioid Use Disorder Quality Standard provides guidance on the care for people 16 years of age and older who have or are suspected of having opioid use disorder. The quality standard applies to all services and care settings.

The quality standard includes 11 quality statements and one emerging practice statement addressing areas that have high potential for improving the quality of care in Ontario for people with opioid use disorder.

Below is a sample of tools that may help you with the implementation of the quality statements into practice, organized according to purpose. Many of these tools will help to support multiple quality statements.

This list is not exhaustive. Are there other tools or resources you use? Do you have experience implementing these tools? If so, please use the comments section below to share!

Comprehensive resources related to opioid use disorder

• The Opioid Use Disorder tool by the Centre for Effective Practice can support providers in screening and diagnosis of opioid use, and also provides communication tips to guide discussions with patients
• The CRISM National Guidelines for the Clinical Management of Opioid Use Disorder were developed by the Canadian Research Initiative on Substance Misuse

Tools to support clinical practice

• The Methadone and Buprenorphine/Naloxone Toolkit by the Ontario Pharmacists Association can support those wishing to initiate a methadone or buprenorphine/naloxone program in their pharmacy setting
• Sample protocols can support the prescription of buprenorphine/naloxone for use in several care settings:
  • Emergency department protocols, developed by Women’s College Hospital
  • Suboxone protocol, developed at University Health Network-Toronto Rehab Institute Buprenorphine/Naloxone Clinic
• The Clinical Opiate Withdrawal Scale is an 11-item scale to rate common signs and symptoms of opiate withdrawal and can be used to monitor these symptoms over time, while the Subjective Opiate Withdrawal Scale is a self-administered scale for grading opioid withdrawal symptoms
  • Both of these scales can be used to address Quality Statement 7: Treatment of opioid withdrawal symptoms

Educational opportunities for health care professionals

The Ontario Pain Management Resources website by Health Quality Ontario includes an up-to-date list of educational resources for health care professionals.

Additional educational resources specific to opioid use disorder include:

• The Opioid Dependence Treatment (ODT) Certificate Program from the Centre for Addiction and Mental Health is intended to prepare physicians, pharmacists, nurses and counsellors to provide a comprehensive range of services for people with opioid dependence
• The Methadone Program from the College of Physicians and Surgeons of Ontario outlines the expectations for physicians who will be prescribing methadone
• Project ECHO Ontario Mental Health hosts weekly CME-accredited videoconferencing sessions to build capacity in the treatment and management of mental health and addictions

Resources for patients and families

These resources support Statement 4: Information to participate in care and Statement 5: Opioid agonist therapy as first-line therapy in this quality standard.

• The Managing my Pain and Pain U Online resources by the Toronto Academic Pain Medicine Institute are intended to support patients in self-management
• Opioid Use Disorders: A guide for patientsand other resources developed by META:PHI provide patients with information about opioid use disorders
• The Patient Reference Guide for the Opioid Use Disorder Quality Standard by Health Quality Ontario helps patients understand what to ask for when receiving treatment for opioid use disorders
• Making the Choice, Making It Work: Treatment for Opioid Addiction by the Centre for Addiction and Mental Health is intended to answer patients’ questions about opioid agonist therapy

Access to local programs and supports

• Rapid Access Addiction Medicine clinics are low-barrier, walk-in clinics across Ontario that provide pharmacotherapy, brief counselling and referrals to community-based services for substance use disorders
• ConnexOntario provides information on treatment services and supports for substance use and mental health conditions
• Where to get a free naloxone kit by the Government of Ontario provides a map of locations that provide naloxone kits and training on how to use them
• The list of LHIN-specific resources related to pain management hosted by the Centre for Effective Practice may be helpful to identify local resources when needed
• The Toronto Public Health Harm Reduction Program (The Works) provides a list of agencies providing harm reduction services

Other resources

• Check out related quality standards from Health Quality Ontario: Opioid Prescribing for Acute Pain and Chronic Pain, Major Depression, and Anxiety Disorders (in development)

Comment below to describe your experience with these tools or share any others you have found useful!