Guest Editorial Illicit Opioid Use and Treatment for Opioid Dependence: Challenges for Canada and Beyond

he use and misuse of opioids has been a phenomenon in Canada for about a century, yet it only began to receive attention in the field of psychiatry when the dominant criminal model was challenged by emerging views on treatment and rehabilitation for addictive diseases (1,2). In this issue of The Canadian Journal of Psychiatry, we offer a comprehensive review of the current epidemiology and related consequences of illicit opioid use as it occurs in marginalized illicit drug users in Canada, as well as the evidence base for treatment interventions currently available in Western countries. While the stereotype of the “heroin junkie ” has shaped the imagery of opioid addiction in North America for almost a century (3,4), the review by Fischer and others (5) instructs us that the contemporary phenomenon of illicit opioid use in Canada is actually much more diverse. As shown by data fro