Speaker: Dr. Nathaniel Day
Session Description:
Opioid Agonist Therapy (OAT) prescribing in Canada is guided by a range of national and provincial recommendations. While these frameworks have contributed to important standardization, clinicians across practice settings have identified significant limitations in their scope and applicability to real‑world care. Existing guidance has not consistently addressed key environments such as correctional settings, has provided limited direction on emerging therapies, including injectable buprenorphine, and has inadequately considered the needs of complex populations such as individuals with acquired brain injury and youth with opioid use disorder. In addition, prior recommendations have often emphasized patient preference without sufficient integration of clinical effectiveness, functional outcomes, and broader system‑level considerations.
In response, the Canadian Centre of Recovery Excellence (CoRE) convened a committee of experienced addiction medicine physicians representing community, hospital, detoxification, and correctional practice environments from across Canada. The objective was to develop comprehensive, evidence‑informed, and practical guidance that reflects contemporary clinical realities and supports outcome‑oriented decision‑making for clinicians and their teams.
A structured Delphi consensus process was employed to systematically examine areas of uncertainty, variation, and emerging practice in OAT prescribing. Through iterative rounds of review and feedback, participants critically evaluated existing evidence, emerging innovations, and domains where formal evidence was limited but clinical experience substantial. Consensus was achieved across key domains, including treatment initiation, transitions of care, novel formulations, special populations, and patient‑centered approaches grounded in measurable clinical outcomes.
This presentation will outline the rationale and methodology of the Delphi process, review the OAT treatment recommendations contained within the new guidelines, and discuss implications for improving consistency, supporting evidence‑informed clinical decision‑making, and strengthening quality of care across addiction medicine systems in Canada.
Learning Objectives:
- New and innovative OAT treatment
- Challenging current treatment regimens and metrics
- Providing Practiced based guidance
References:
https://pubmed.ncbi.nlm.nih.gov/41571617
https://pubmed.ncbi.nlm.nih.gov/41192276
https://pubmed.ncbi.nlm.nih.gov/41558014
https://pubmed.ncbi.nlm.nih.gov/41521864
https://pubmed.ncbi.nlm.nih.gov/41520950
https://pubmed.ncbi.nlm.nih.gov/41490116
BIO:
Dr. Nathaniel Day, MD CCFP Dip. ABAM CHE
Dr. Nathaniel Day is the Chief Scientific Officer at the Canadian Centre of Recovery Excellence, providing expert guidance on program evaluation and development. Dr. Day is an addiction medicine specialist with a medical degree from the University of Alberta, serves as the Provincial Medical Director of Addiction within the addiction and mental health and correctional health services portfolio with Alberta Health Services, served as the medical director for the Centennial Centre for Mental Health and Brain Injury, and Alberta’s Virtual Opioid Dependency Program. With his team at Alberta Health Services, he conceptualized and developed the innovative Virtual Opioid Dependency Program. Dr. Day also served on the Minister’s Opioid Emergency Response Commission and co-chaired the Recovery Expert Advisory Panel. His work has been recognized by provincial and national bodies.