Study: Increased access to take-home treatments reduces the risk of overdose

According to the results of a new study examining patients receiving treatment for opioid addiction in Ontario, a recommendation change in March 2020 that allowed for more take-home treatments during the pandemic resulted in less overdoses and in increased retention of patients in the program.

Specifically, the study, published in the journal JAMA, followed over 21,000 patients who were receiving opioid agonist therapy (OAT) in 2020 and found that among patients who were receiving daily doses of methadone, patients who moved to take-home doses were actually 27% less likely to have an opioid-related overdose.

Moreover, the study authors have suggested that providing more flexible access to addiction treatment in the future could serve as an important step to reduce the number of opioid overdoses.

“Allowing people to have that agency over treatment and given that opportunity is really important in independence and in confidence building,” said Charlotte Munro, one of the study’s co-authors and a member of the Ontario Drug Policy Research Network’s (ODPRN) lived experienced advisory board, in her interview with CTV News.

Currently, OAT is the standard treatment for opioid addiction, which involves regular doses of either methadone or buprenorphine, both of which are long-acting opioid drugs.

“They’re oral medications that are taken that replace opioids that people might have taken instead and help people prevent themselves from going into withdrawal and maintain a steady state of opioid in their system,” said Dr. Tara Gomes, a Principal Investigator of ODPRN and lead author of the study.

Since OAT involves administration of controlled substances that carries a risk of overdose, particularly methadone, the treatment is delivered daily, in-person at a pharmacy for a period of time until a physician allows the patient to take more doses to take at home.

“It’s a very restrictive program,” said Dr. Gomes. “For some people, they will continue getting daily dispensed methadone for months, years at a time.”

During the onset of the COVID-19 pandemic, physicians in Ontario and other Canadian provinces received recommendations to allow patients quicker access to take home doses, or access to more take home doses at once.

Although health practitioners had already been advocating for increased patient access to OAT, some had also voiced concern about increased incidence of patient overdoses.

However, the results of the research study showed that individuals receiving daily doses of methadone not only had a lower risk of overdoses when they transitioned to take-home doses compared to patients who did not receive take-home doses, but that they were also 20% less likely to have their treatment interrupted or to discontinue treatment.

In addition, patients who received an increase from a one-week supply of methadone to at least a two-week supply had a 28% reduction in discontinuing treatment and a 31% reduction in treatment interruption compared to those who didn’t receive any increase.

There was also no increased risk of overdose in this group, indicating that this could be an effective way to deliver essential treatment to patients with “more trust and flexibility, while also not compromising patients’ safety.”

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