A more flexible model of care than methadone can be as effective in treating opioid use disorder, according to a pan-Canadian study led by Université de Montréal psychiatry and addictology professor Didier Jutras-Aswad.
More than 26,500 Canadians died from opioid intoxication between January 2016 and September 2021, and in Quebec alone, 339 people died from opioid intoxication between January and September 2021, according to the Public Health Agency of Canada.
The team of researchers compared the efficacy of two models of care for treating opioid use disorder, and there’s new evidence that a more flexible model of care than methadone can be as effective. Methadone must be taken under close supervision at a pharmacy, is often viewed as restrictive and supervision requirements limit easy access to it.
The new model of care is based on prescribing buprenorphine-naloxone, known commercially as Suboxone. The study recruited more than 270 adult volunteers in seven hospitals and clinics in Quebec, Ontario, Alberta and British Columbia. Participants took Suboxone at home starting in their first weeks of treatment, proven as effective as methadone without needing close supervision.
With an average age of 39, and with one in three a woman, all presented problematic opioid use from either prescribed or illegally produced opioids. Among the opioids inventoried were hydromorphone, morphine, oxycodone and fentanyl.
Despite appeals in recent years for greater awareness of substance use disorders, the stigma surrounding people with these addictions still hampers access to safe, suitable and evidence-based treatment, said Jutras-Aswad. “With the health restrictions and limitations on follow-up visits in healthcare settings we’ve seen during the COVID-19 pandemic, I think we’ve come to realize more and more that Canadians need more flexible treatment options.”
Today, Canada is among the world’s top consumers of opioids, whether medically prescribed or obtained illegally from illicit producers of very powerful substances such as fentanyl.
Just this week, all Canadian province’s and territories reached a $150 million settlement with OxyContin manufacturer Purdue Pharma Canada to recoup. American and Canadian healthcare systems have been hit with the costs of treating the fallout of opioid abuse, something many say resulted from misleading marketing of opioid-based pain control drugs.
The results of the study were published in the American Journal of Psychiatry.