Investigating opioid preference to inform safe supply services: A cross sectional study

Ferguson, Max; Parmar, Amrit; Papamihali, Kristi; Weng, Anita; Lock, Kurt; Buxton, Jane A.

doi:10.1016/j.drugpo.2021.103574

Cited by 21 publications

(21 citation statements)

References 24 publications

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“…In other settings, dosages may need to be higher than those recommended in these guidelines or different medications may be for effective. For example, a recent survey of people who use drugs in British Columbia, Canada, showed that in that province most would prefer heroin or fentanyl safe supply over prescription opioids like hydromorphone ( Ferguson et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness

Brothers

Leaman²,

Bonn³

et al. 2022

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 99%

Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness

Brothers

Leaman²,

Bonn³

et al. 2022

Drug and Alcohol Dependence

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“…Nevertheless, the range of options and reach of this prescribing remains limited, often available only to people with clinical diagnoses of stimulant use disorder and prescribed for daily dispensation at community pharmacies. A wider diversity of alternatives to the illicit drug supply are required to support people with diverse motivations for, patterns of, and goals around their opioid and stimulant use, which may or may not include abstinence [36].…”

Section: Discussionmentioning

confidence: 99%

“…This decline may reflect that current treatment options are not meeting the preferences of many people who use opioids in BC. For example, more than 70% of people who use opioids and accessed harm reduction sites in BC in 2019 reported smoking opioids [39], and approximately 60% reported heroin as their preferred opioid [36]. These preferences for substances and routes of administration are not met by available treatment options.…”

Section: Hr (95%ci) P-value Hr (95%ci) P-valuementioning

confidence: 99%

Concurrent use of opioids and stimulants and risk of fatal overdose: A cohort study

et al. 2022

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Background Stimulant use has been rising among people with opioid use disorder in recent years in North America, alongside a parallel rise in illicit drug toxicity (overdose) deaths. This study aimed to examine the association between stimulant use and overdose mortality. Methods Data from a universal health insurance client roster were used to identify a 20% random general population sample (aged ≥12) in British Columbia, Canada between January 1 2015 and December 31 2018 (N = 1,089,682). Provincial health records were used to identify people who used opioids and/or stimulants. Fatal overdose observed during follow-up (January 12,015- December 312,018) was retrieved from Vital Statistics Death Registry and BC Coroners Service Data. Potential confounders including age, sex, health region, comorbidities and prescribed medications were retrieved from the provincial client roster and health records. Results We identified 7460 people who used stimulants and or opioids. During follow-up there were 272 fatal overdose events. People who used both opioids and stimulants had more than twice the hazard of fatal overdose (HR: 2.02, 95% CI: 1.47-2.78, p < 0.001) compared to people who used opioids only. The hazard of death increased over time among people who used both opioids and stimulants. Conclusions There is an urgent need to prioritize the service needs of people who use stimulants to reduce overdose mortality in British Columbia. Findings have relevance more broadly in other North American settings, where similar trends in opioid and stimulant polysubstance use have been observed.

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“…Since the introduction of slow-release opioids such as morphine and oxycodone to the Canadian market in 1999, dependence on opioids in Canada has increased dramatically, with 21.7 million prescriptions administered in 2014 (Eibl et al, 2017). In addition to dependence and addiction increases led by prescription opioids, a growing concern for public health officials is the rise of synthetic opioids in the illicit drug supply, including fentanyl, increasingly found in heroin samples across Canada (Lisa and Jessica, 2018;Ferguson et al, 2022). Fentanyl is up to 100 times stronger than morphine, and appeared in 87% of the 3,515 opioid toxicity deaths in Canada in the first half of 2021 (Special Advisory Committee on the Epidemic of Opioid Overdoses, 2021).…”

Section: Opioid Use Disorder and Opioid Agonist Treatmentmentioning

confidence: 99%

Access to Opioid Agonist Treatment during COVID-19 Public Transport Disruptions

Yucel¹,

Higgins²,

Gupta³

et al. 2022

Preprint

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Public transport disruptions caused by the COVID-19 pandemic had wide-ranging impacts on the ability of individuals to access health care. Individuals with opioid use disorder represent an especially vulnerable population due to the necessity of frequent, supervised doses of opioid agonists. Focused on Toronto, a major Canadian city suffering from the opioid epidemic, this analysis uses novel realistic routing methodologies to quantify how travel times to individuals' nearest clinics changed due to public transport disruptions from 2019 to 2020. This analysis uses entirely open-source data sources to estimate the vulnerable populations that were impacted by the largest transport disruptions in the city's history. Individuals seeking opioid agonist treatment face very constrained windows of access due to the need to manage work and other essential activities. As even small changes to travel times can lead to missed appointments and heighten the chances of overdose and death, understanding the distribution of those most impacted can help inform future policy measures to ensure adequate access to care.

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Investigating opioid preference to inform safe supply services: A cross sectional study

Cited by 21 publications

References 24 publications

Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness

Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness

Concurrent use of opioids and stimulants and risk of fatal overdose: A cohort study

Access to Opioid Agonist Treatment during COVID-19 Public Transport Disruptions

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