Tara Gomes

Comparing the effects of prescribed safer opioid supply and methadone in Ontario, Canada: a population-based matched cohort study Prescribed safer opioid supply (SOS) programmes are novel harm reduction interventions. We examined health outcomes among people receiving SOS over ti…

Thanks to @gilliankolla.bsky.social , Ahmed Bayoumi, Tony Antoniou, Sam Young, Ashley Smoke, and the
@odprn.bsky.social team for the support with this project!

Full article can be found here:
sciencedirect.com/science/arti...

Taken together, these findings demonstrate that both methadone and Safer Supply are important options within the suite of services needed to improve the health and reduce risks of harms for people who use drugs in our community.

When looking at all outcomes (not just those when on treatment), the benefits of methadone over SOS largely disappeared, with the exception of toxicities, which remained slightly lower for methadone. This is likely due to higher baseline toxicity risk among SOS recipients.

When comparing methadone to SOS, rates of most outcomes *when on treatment* were lower among those starting methadone; however people were more likely to discontinue methadone compared to SOS over the first year of treatment.

Similarly, people newly starting methadone had significant improvements in outcomes. For both SOS and methadone, all-cause and opioid-related deaths were exceptionally rare.

Now to outcomes. SOS recipients had significant improvements in ALL outcomes studied, including reduced rates of opioid toxicities, ED visits, inpatient hospitalizations, new infections, mental health and SUD hospitalizations, and healthcare $.

Importantly, prior OAT exposure was high among SOS recipients. Approximately 90% of people had tried OAT in the past year.

Given these differences, we were unable to find people among the >25,000 new methadone recipients who were similar clinically to the ~1,000 new SOS recipients. We simply couldn't find a similar methadone recipient for ~10% of SOS recipients in the study.

First: Safer Supply in Ontario is reaching people with complex healthcare needs. Compared to people starting methadone, new SOS recipients were more likely to have prior serious infections, opioid toxicities, hepatitis C, HIV and alcohol use disorder.

Our new study on outcomes among people accessing #SaferOpioidSupply is out in @thelancetph.bsky.social. This study builds on work published previously across the country reinforcing the real-world benefits of #SOS and highlighting important comparisons with methadone. 🧵