If British Columbia is a pioneering province for research and clinical care in harm reduction in Canada, then pharmacist Amin Janmohamed is an innovator among B.C. health-care professionals leading that work. 

Since April 2016, British Columbia has maintained a public health emergency in the toxic drug crisis. Now in the tenth year of the crisis, the body count stands at more than 18,000 lives lost, with the opioid fentanyl consistently being identified as the most active killer. 

Without Janmohamed, those who came before him, and those who work alongside him, undoubtedly, the number of deaths would be far higher. 

There is a need to expand treatment options by adding another tool to better support individuals with opioid use disorder, particularly those who have not benefited from existing approaches.

— Amin Janmohamed

Treatment for opioid use disorder is hardly new — a doctor in British Columbia pioneered the first opioid agonist therapy more than six decades ago when methadone was introduced as maintenance therapy for opioid dependence. 

For years, methadone was virtually the only option to treat opioid dependence, until the NAOMI trials in 2005. The North American Opiate Medication Initiative (NAOMI) aimed to examine injected diacetylmorphine as a therapeutic option to treat long-term opioid users. Janmohamed was a pharmacist contributor to that program, and following NAOMI, he worked as a co-investigator for the Study to Assess Long-Term Opioid Medication Effectiveness (SALOME), which compared both injected hydromorphone and diacetylmorphine, determining that the former was as effective as the latter in substance use treatment. 

Following these clinical trials, it became clear that the work could not end at research, as patients needed ongoing access to treatment, which led Janmohamed to establish injectable opioid agonist treatment compounding and pharmacy services at Providence Crosstown Clinic and contribute to the injectible opioid agonist treatment guidelines of the British Columbia Centre on Substance Use.

More recently, his work has turned from injectable treatment towards inhaled treatment, in recognition that a growing number of people with opioid use disorder now inhale the substances rather than inject. As part of that work, he developed a diacetylmorphine base for heat inhalation, a formulation not previously available in Canada. 

“More than 70 per cent of people with opioid use disorder using unregulated substances are now inhaling rather than injecting,” Janmohamed said. “We’re now finding out that there’s a whole segment of public-health need that’s not being addressed. I looked at the evidence and found ways that we could compound inhalable diacetylmorphine.”

To compound inhalable diacetylmorphine, in 2025, Janmohamed led the development of Central Compound Pharmacy, a closed-door compounding pharmacy in Vancouver that specializes in high-complexity hazardous compounding, designed to support centralized compounding and enable access for pharmacies across B.C. 

“Looking for solutions is something I really enjoy. Caring for individuals that are disenfranchised, or have unmet health-care needs, is also important to me, and when you mix those two together, it's very motivating,” he said. 

“There is a need to expand treatment options by adding another tool to better support individuals with opioid use disorder, particularly those who have not benefited from existing approaches.” 

Creating the pharmacy was an involved process, which included custom engineering to handle hazardous materials, plus procuring Health Canada-approved active pharmaceutical ingredients from abroad. 

“I'm thankful to be able to work with many different individuals and institutions, from researchers, physicians, nurse practitioners, nurses, social workers, peers, and so on.

“Innovation isn't isolated to one person. It takes a community to innovate.”