Abstract
Reduction in Substance Use-Related Harms Among a Cohort of People Receiving Injectable Opioid Agonist Treatment in Ontario, Canada
Drug and alcohol dependence, v 260, pp 111-111
01 Jul 2024
Abstract
Aim: For people with severe opioid use disorder and at high risk of overdose, injectable opioid agonist treatment (iOAT) has been proposed as a safe, low-barrier, and effective intervention. In Ontario, Canada, an iOAT program run by The Works (Toronto Public Health) was established in 2021 and dispenses daily witnessed injectable hydromorphone with overnight slow-release oral morphine or methadone. iOAT clients self-administer hydromorphone inside a medically-supervised setting providing wraparound harm reduction, health and social services. We undertook a preliminary assessment of substance use-related outcomes among people who inject drugs (PWID) following their initiation of iOAT at The Works.
Methods: Using an interviewer-administered questionnaire, data were obtained from a cohort of Toronto PWID aged 18+ who regularly injected opioids and attended the iOAT clinic at least once daily. We assessed the prevalence of self-reported recent overdose at most recent follow-up visits compared with its 6-month prevalence at baseline, before the initiation of iOAT. We also compared daily fentanyl and heroin injection frequencies at baseline and follow-up.
Results: 47 PWID with a median (IQR) age of 38 (34–46) years at baseline were followed up for a median (IQR) of 3 (1.5–4.5) months. 74.5% (n=35) were men, and 78.7% (n=37) self-identified as White/Caucasian. During follow-up, 14.28% (n=4) self-reported overdosing in the past month compared with 85.1% (n=40) who reported overdosing during the past six months at baseline (P-value<0.001). Daily fentanyl and heroin injections declined from 63.8% (n=30) and 6.4% (n=3) at baseline to 37.0% (n=10) and 0.0% (n=0) during follow-up, respectively (P-values<0.001).
Conclusions: In a preliminary assessment, PWID receiving iOAT had significantly fewer overdose events and less unregulated opioid injection over time. Future real-world implementation experiences of iOAT with larger sample sizes and control groups are needed to characterize the potential impacts of this modality in the synthetic opioid era.
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Details
- Title
- Reduction in Substance Use-Related Harms Among a Cohort of People Receiving Injectable Opioid Agonist Treatment in Ontario, Canada
- Creators
- Tinkhani Mbichila - Unity Health TorontoMohammad Karamouzian - St. Michael's HospitalZachary Bouck - Unity Health TorontoAhmed Bayoumi - Unity Health TorontoBijan Rafat - Unity Health TorontoCarman Brown - Unity Health TorontoShaun Hopkins - Toronto Public HealthAyden Scheim - Drexel UniversityDan Werb - Unity Health Toronto
- Publication Details
- Drug and alcohol dependence, v 260, pp 111-111
- Conference
- 2023 Annual Meeting of the College on Problems of Drug Dependence (Denver, Colorado, United States, 17 Jun 2023–21 Jun 2023)
- Publisher
- Elsevier; CLARE
- Number of pages
- 1
- Grant note
- Financial Support: Canadian Institutes of Health Research
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001280690400412
- Other Identifier
- 991021894100104721
InCites Highlights
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychiatry
- Substance Abuse