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Analysis from ICES and Unity Well being Toronto reveals that safer opioid provide packages and methadone each scale back opioid overdoses, well being care utilization, and prices.
The work seems in The Lancet Public Well being.
Safer opioid provide (SOS) packages present pharmaceutical-grade opioids akin to hydromorphone to folks battling opioid use dysfunction. Prescribed opioid medicines are a safer various to medication discovered within the unregulated drug provide because of the efficiency and unpredictability of that offer.
“This is the first population-based study to compare SOS programs with opioid agonist treatment, and to explore how people’s outcomes change in the year after initiation,” says Dr. Tara Gomes, a scientist on the Li Ka Shing Information Institute of St. Michael’s Hospital and ICES, and a principal investigator of the Ontario Drug Coverage Analysis Community (ODPRN).
The researchers in contrast well being outcomes amongst folks newly prescribed SOS and people newly beginning methadone as opioid agonist remedy (OAT) between 2016 and 2021, in Ontario, Canada, with follow-up extending to the tip of 2022.
The examine recognized 991 folks newly prescribed SOS and 26,116 new OAT (methadone) customers. Sufferers prescribed SOS confronted extra medical points, together with larger charges of HIV, hepatitis C, earlier opioid overdoses, and infections, suggesting that folks prescribed safer provide had been usually extra medically advanced than folks prescribed methadone when beginning remedy.
The researchers matched 856 new SOS sufferers to an equal variety of methadone recipients who had comparable well being situations, demographics, and lived in comparable components of the province. The report discovered that folks in each the SOS and methadone teams had vital declines in opioid overdoses, emergency division (ED) visits, hospitalizations, new infections, and well being care prices within the subsequent yr.
In each teams, deaths associated to opioids or some other trigger had been unusual.
SOS and methadone therapies complementary
Whereas each SOS and methadone recipients had an general decrease threat of overdose and poor well being outcomes whereas on remedy, in a comparative evaluation, people beginning methadone had a barely decrease threat of experiencing an opioid overdose and being admitted to hospital in comparison with folks beginning safer provide.
Nevertheless, folks beginning methadone had been extra prone to discontinue remedy. After accounting for the upper price of remedy drop-out within the methadone group, a lot of the advantages of methadone over SOS disappeared, apart from toxicities, which remained barely decrease amongst these receiving methadone.
“Neither methadone nor safer supply programs are a one-size-fits-all solution, but our findings show that both are effective at reducing overdose and improving health outcomes,” provides Gomes. “They are complementary to each other, and for many people who haven’t found success with traditional treatments like methadone, safer supply programs offer a lifeline. Our findings show that when safer supply programs are implemented, we see fewer hospital visits, fewer infections, and fewer overdoses.”
The authors speculate that the completely different patterns of unregulated drug use between the 2 teams and the upper severity of opioid use dysfunction amongst SOS recipients could partly account for why the chance of opioid overdose was decrease amongst methadone recipients in comparison with folks receiving safer provide.
“These findings highlight the value of including safer supply alongside OAT in our toolbox of programs and services designed to support people at risk of overdose in Ontario,” says Gomes. “Safer opioid supply programs are reaching those with high medical complexity and a history of serious harms from drug use—those in our community who need support the most.”
Extra info:
Evaluating the results of prescribed safer opioid provide and methadone in Ontario, Canada: a population-based matched cohort examine, The Lancet Public Well being (2025). DOI: 10.1016/S2468-2667(25)00070-2
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Safer opioid provide improves well being outcomes amongst folks at excessive threat of overdose (2025, April 22)
retrieved 22 April 2025
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