{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:11:43Z","timestamp":1790255503747,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T00:00:00Z","timestamp":1495152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p>Opioid agonist therapy was introduced in Canada in 1959 with the use of methadone for the treatment of opioid dependence. The regulation of methadone was the responsibility of Health Canada until 1995, when oversight was transferred to the provincial health systems. During the more than 20 years since the federal health authority transferred oversight of methadone to the provincial level, methadone programming has evolved differently in every province. The landscape of opioid dependence treatment is varied across the country, with generally increasing treatment capacity in all provinces and dramatic increases in some. Each province has an independent methadone program with differing policies, contingency management strategies, laboratory monitoring policies, and delivery methods. Treatment options have increased, with buprenorphine- and heroin-assisted treatment becoming available to limited degrees. Despite this, access remains a challenge in many parts of the country (particularly rural and remote areas) because the demand for treatment has increased even more rapidly than the capacity. Although treatment access remains a priority in many jurisdictions, there is also a need to attend to treatment quality as treatment access expands, including integration with addiction counselling, primary care, and mental health care. As well, coordinated monitoring and reporting of treatment need, quality, and delivery are required; implementing a national policy to promote planning would have tremendous value.<\/jats:p>","DOI":"10.1177\/0706743717711167","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T13:55:38Z","timestamp":1495202138000},"page":"444-450","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":91,"title":["The State of Opioid Agonist Therapy in Canada 20 Years after Federal Oversight"],"prefix":"10.1177","volume":"62","author":[{"given":"Joseph K.","family":"Eibl","sequence":"first","affiliation":[{"name":"Northern Ontario School of Medicine, Sudbury, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Morin","sequence":"additional","affiliation":[{"name":"Laurentian University, Sudbury, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esa","family":"Leinonen","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine, Sudbury, Ontario"},{"name":"Canadian Addiction Treatment Centers, Richmond Hill, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Marsh","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine, Sudbury, Ontario"},{"name":"Canadian Addiction Treatment Centers, Richmond Hill, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,5,19]]},"reference":[{"key":"bibr1-0706743717711167","first-page":"412","volume":"5","author":"Halliday R","year":"1963","journal-title":"B C Med J"},{"key":"bibr2-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1965.03090080008002"},{"key":"bibr3-0706743717711167","doi-asserted-by":"publisher","DOI":"10.2307\/3343343"},{"issue":"4","key":"bibr4-0706743717711167","first-page":"399","volume":"157","author":"Brands B","year":"1997","journal-title":"CMAJ"},{"key":"bibr5-0706743717711167","doi-asserted-by":"publisher","DOI":"10.3109\/16066350009005592"},{"key":"bibr6-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000156"},{"issue":"1","key":"bibr7-0706743717711167","first-page":"22","volume":"39","author":"Nosyk B","year":"2010","journal-title":"Canada: 1996-2006. J Subst Abuse Treat"},{"key":"bibr8-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/753409"},{"key":"bibr9-0706743717711167","volume-title":"A cross-Canada scan of methadone maintenance treatment policy developments","author":"Luce J","year":"2011"},{"key":"bibr10-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1111\/add.12598"},{"issue":"3","key":"bibr11-0706743717711167","first-page":"e92","volume":"57","author":"Dhalla IA","year":"2011","journal-title":"Can Fam Physician"},{"issue":"9","key":"bibr12-0706743717711167","first-page":"826","volume":"60","author":"Gomes T","year":"2014","journal-title":"Can Fam Physician"},{"key":"bibr13-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1177\/1715163512473928"},{"issue":"5","key":"bibr14-0706743717711167","first-page":"204","volume":"145","author":"Lynas K","year":"2013","journal-title":"Can Pharm J (Ott)"},{"key":"bibr15-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2015-041604"},{"key":"bibr16-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000431"},{"key":"bibr17-0706743717711167","author":"Woo A","year":"2015","journal-title":"The Globe and Mail (Vancouver)"},{"key":"bibr19-0706743717711167","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20140027"},{"key":"bibr20-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1007\/BF03403970"},{"key":"bibr21-0706743717711167","unstructured":"National Opioid Use Guideline Group. Canadian guideline for safe and effective use of opioids for chronic non-cancer pain. Hamilton (ON): McMaster Press; 2010."},{"key":"bibr22-0706743717711167","unstructured":"Health Canada. Best practices: methadone maintenance treatment. Ottawa (ON): Health Canada; 2002."},{"key":"bibr23-0706743717711167","unstructured":"World Health Organization. Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva (Switzerland): World Health Organization; 2009."},{"key":"bibr24-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.05.010"},{"key":"bibr26-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1111\/add.12269"},{"key":"bibr27-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1575"},{"key":"bibr28-0706743717711167","volume-title":"Methadone exemption application","author":"Health Canada","year":"2015"},{"key":"bibr29-0706743717711167","volume-title":"Non-insured health benefits (NIHB) medical transportation policy framework","author":"First Nations and Inuit Health (FNIH)","year":"2015"},{"key":"bibr30-0706743717711167","volume-title":"Population by year, by province and territory","author":"Statistics Canada","year":"2013"},{"key":"bibr31-0706743717711167","unstructured":"Centre de Recherche et d\u2019Aide pour Narcomanes (CRAN). Enseignement & innovation, une rel\u00e8ve pour demain. Montreal (QC): CRAN; 2014."},{"key":"bibr32-0706743717711167","volume-title":"La dependance aux opioides: portrait des traitements de substitution au Qu\u00e9bec","author":"Centre de Recherche et d\u2019Aide pour Narcomanes (CRAN)","year":"2011"},{"key":"bibr34-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-1-9"},{"key":"bibr35-0706743717711167","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2006.0006"},{"key":"bibr36-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.05.002"},{"key":"bibr37-0706743717711167","unstructured":"College of Physicians and Surgeons of Ontario. Paper presented at: CPSO Methadone Conference; 6 11 2015; Toronto, Canada."},{"key":"bibr38-0706743717711167","unstructured":"Shapiro. Telemedicine and addiction: an indicator of things to come. Paper presented at: Northern Health Research Conference; 2015."},{"key":"bibr39-0706743717711167","author":"Fisher MHA","year":"2014","journal-title":"Manitoba, Canada: Addictions Foundation of Manitoba"},{"key":"bibr41-0706743717711167","unstructured":"Virani H. What\u2019s up with down: treatment of opioid use disorder in Alberta. Paper presented at: the Canadian Society of Addiction Medicine annual conference. 12 November 2015; Banff, Alberta, Canada."},{"key":"bibr43-0706743717711167","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810635"},{"key":"bibr44-0706743717711167","author":"Keller J","year":"2014","journal-title":"National Post"},{"issue":"3","key":"bibr45-0706743717711167","first-page":"23","volume":"10","author":"Herget G","year":"2005","journal-title":"HIV AIDS Policy Law Rev"}],"container-title":["The Canadian Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0706743717711167","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0706743717711167","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0706743717711167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:14:37Z","timestamp":1777392877000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/0706743717711167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,19]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1177\/0706743717711167"],"URL":"https:\/\/doi.org\/10.1177\/0706743717711167","relation":{},"ISSN":["0706-7437","1497-0015"],"issn-type":[{"value":"0706-7437","type":"print"},{"value":"1497-0015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,19]]}}}