Injectable diacetylmorphine might provide more benefits and lower costs compared with oral methadone maintenance therapy in patients with severe opioid use disorder. The Canadian Research Initiative in Substance Misuse guideline recommends that both injectable diacetylmorphine and hydromorphone should be considered as treatment options for individuals with severe, treatment-refractory opioid use disorder and ongoing illicit injection opioid use, and that the injectable opioid agonist treatment

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... hould have an end date to transition to an oral opioid agonist treatment. No recent studies on the clinical effectiveness of diacetylmorphine for injection in comparison with methadone or buprenorphine were identified. No cost-effectiveness studies of injectable diacetylmorphine compared with buprenorphine were identified.