Prescription heroin, a last-resort treatment for severe addiction currently restricted to only one clinic in all of North America, could one day be dispensed at pharmacies much as methadone is. The dispensation model is one of three proposed in a draft of B.C. guidelines for the expansion of supervised injectable opioid-assisted treatment (siOAT). The document, being prepared by the nascent BC Centre on Substance Use (BCCSU), is a first-of-its-kind in North America and reflects the centre’s push to provide a wide range of options for people struggling with substance use.