{"id":21728,"date":"2025-04-22T18:30:00","date_gmt":"2025-04-22T22:30:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21728"},"modified":"2025-04-21T09:05:12","modified_gmt":"2025-04-21T13:05:12","slug":"comparing-the-effects-of-prescribed-safer-opioid-supply-and-methadone-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/comparing-the-effects-of-prescribed-safer-opioid-supply-and-methadone-in-ontario-canada\/","title":{"rendered":"Comparing the effects of prescribed safer opioid supply and methadone in Ontario, Canada: a population-based matched cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Prescribed safer opioid supply (SOS) programmes are novel harm reduction interventions. We examined health outcomes among people receiving SOS over time and relative to a similar group of people receiving methadone.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a population-based cohort study among new SOS and methadone recipients in Ontario, Canada, who commenced treatment between Jan 1, 2016 and Dec 31, 2021. People receiving SOS were matched (1:1) to new methadone recipients based on age (within 3 years), sex, location of residence (public health unit), and propensity score (within 0\u00b72 SDs). Primary outcomes were hospital-treated opioid-related toxicities, emergency department visits and inpatient hospitalisations, incident infections, and health-care costs (in CA$, excluding costs related to primary care services and medications) over 1 year of follow-up. Outcome rates were calculated over the follow-up period, with censoring on death, discontinuation of SOS or methadone, or end of follow-up (360 days). Within-group changes in outcomes were assessed using interrupted time-series analysis, and Prentice\u2013Williams\u2013Peterson regression was used to assess between-group differences in recurrent events.<\/p>\n<p><strong>Findings<\/strong> \u2014 Of the 991 new recipients prescribed SOS and 25116 new methadone recipients who met the eligibility criteria, 856 (86\u00b74%) people receiving SOS were matched to 856 people receiving methadone. In the within-group analysis, matched SOS recipients had significant improvements in the monthly rate of opioid toxicities (step change \u20131\u00b709 events per 100 individuals [95% CI \u20132\u00b712 to \u20130\u00b707]; p=0\u00b7037), all-cause emergency department visits (\u20138\u00b785 per person-year [\u201313\u00b75 to \u20134\u00b720]; p=0\u00b70002), all-cause inpatient hospitalisations (\u20132\u00b708 per person-year [\u20133\u00b741 to \u20130\u00b775]; p=0\u00b70022), incident infections (\u20130\u00b768 per person-year [\u20131\u00b722 to \u20130\u00b714]; p=0\u00b7013), and non-primary\u0002 care-related health-care costs (\u2013$91 699 per person-year [\u2013112749 to \u201370 650]; p&lt;0\u00b70001). Results were consistent for methadone recipients. In the between-group analysis, individuals commencing SOS had significantly higher hazards of opioid toxicity (hazard ratio 2\u00b783 [95% CI 1\u00b797 to 4\u00b706]), emergency department visits (1\u00b716 [1\u00b705 to 1\u00b729]), and inpatient admissions (1\u00b750 [1\u00b713 to 1\u00b799]), no significant difference in the rate of incident infection (1\u00b751 [0\u00b787 to 2\u00b761]), and were less likely to discontinue treatment than those commencing methadone (0\u00b762 [0\u00b755 to 0\u00b770]). When treatment discontinuation was removed as a censoring criterion, we found no difference between groups in the hazard of any of the primary outcomes except opioid toxicity (1\u00b765 [1\u00b738 to 1\u00b797]).<\/p>\n<p><strong>Interpretation<\/strong> \u2014 SOS and methadone were associated with improvements in health outcomes, including reduced opioid toxicities and health-care use, in the year after treatment initiation. The findings suggest SOS programmes play an important, complementary role to traditional opioid agonist treatment in expanding the options available to support people who use drugs.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Prescribed safer opioid supply (SOS) programmes are novel harm reduction interventions. We examined health outcomes among people receiving SOS over time and relative to a similar group of people receiving methadone. Methods \u2014 We conducted a population-based cohort study among new SOS and methadone recipients in Ontario, Canada, who commenced treatment between Jan [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[34,56],"migration-helper-qa-sample-set":[],"class_list":["post-21728","journal_article","type-journal_article","status-publish","hentry","topic-mental-health-and-addictions","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Gomes T, McCormack D, Kolla G, Young S, Bayoumi A, Smoke A, Li P, Antoniou T. <em><span class=\"highlight\">Lancet<\/span>\u00a0<\/em><span class=\"highlight\"><em>Public Health<\/em>. 2025; Apr 22.<\/span>","source_url":"https:\/\/doi.org\/10.1016\/ S2468-2667(25)00070-2","ices_scientist":[1252,1170,1386],"site":[6733],"research_program":[6746],"news_release":[21727],"journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Comparing the effects of prescribed safer opioid supply and methadone in Ontario, Canada: a population-based matched cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Prescribed safer opioid supply (SOS) programmes are novel harm reduction interventions. 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