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Factors associated with 60-day adherence to "safer supply" opioids prescribed under British Columbia's interim clinical guidance for health care providers to support people who use drugs during COVID-19 and the ongoing overdose emergency.
Selfridge, Marion; Card, Kiffer; Kandler, Taylor; Flanagan, Erin; Lerhe, Emily; Heaslip, Ash; Nguyen, Anne; Moher, Matthew; Pauly, Bernie; Urbanoski, Karen; Fraser, Chris.
  • Selfridge M; Cool Aid Community Health Centre, Victoria, BC, Canada; Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada. Electronic address: marions@uvic.ca.
  • Card K; Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; Simon Fraser University, Faculty of Health Sciences, Canada.
  • Kandler T; University of British Columbia, Faculty of Medicine, Canada.
  • Flanagan E; University of British Columbia, Faculty of Medicine, Canada.
  • Lerhe E; University of British Columbia, Faculty of Medicine, Canada.
  • Heaslip A; Cool Aid Community Health Centre, Victoria, BC, Canada; University of British Columbia, Faculty of Medicine, Canada.
  • Nguyen A; Cool Aid Community Health Centre, Victoria, BC, Canada; University of British Columbia, Faculty of Medicine, Canada; University of Victoria, Faculty of Medicine, Canada.
  • Moher M; Cool Aid Community Health Centre, Victoria, BC, Canada; University of British Columbia, Faculty of Medicine, Canada; University of Victoria, Faculty of Medicine, Canada.
  • Pauly B; Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; University of Victoria, School of Nursing, Canada.
  • Urbanoski K; Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; University of Victoria, School of Public Health and Social Policy, Canada.
  • Fraser C; Cool Aid Community Health Centre, Victoria, BC, Canada; University of British Columbia, Faculty of Medicine, Canada.
Int J Drug Policy ; 105: 103709, 2022 07.
Article in English | MEDLINE | ID: covidwho-1819474
ABSTRACT

AIMS:

In March 2020, British Columbia issued Risk Mitigation Guidance (RMG) to support prescribing of pharmaceutical alternatives to illicit drugs, in order to reduce risk for COVID-19, overdose, and withdrawal among people who use drugs. This study evaluated factors associated with 60-day adherence to novel opioid alternatives prescribed at an inner-city health centre in Victoria, Canada.

METHODS:

A chart review was conducted to collect data on sociodemographic information, medical histories, and follow-up services among all clients prescribed novel opioid alternatives from March 2020-August 2020 (n = 286). Bivariable and multivariable regression were used to identify independent and adjusted factors associated with 60-day adherence.

RESULTS:

Overall, 77% of 286 clients were still receiving opioids after 60 days of follow-up. Medications included hydromorphone (n = 274), sustained-release oral morphine (n = 2), and oxycodone (n = 9). The adjusted odds of 60-day adherence to novel opioid alternatives were significantly higher for those receiving a mental health medication (aOR = 3.49, 95%CI = 1.26, 11.00), a higher maximum daily dosage of RMG prescriptions (aOR = 1.03 per mg increase, 95%CI = 1.01, 1.04), and those with continuous receipt of OAT (aOR = 6.25, 95%CI = 2.67, 15.90).

CONCLUSIONS:

Higher dosages and co-prescription of mental health medications and OAT may help support better adherence to this form of prescriber-based "safer supply". Further work is needed to identify optimal prescribing practices and the longer term impacts of differing implementation scenarios.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Int J Drug Policy Journal subject: Public Health / Substance-Related Disorders Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Overdose / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: North America Language: English Journal: Int J Drug Policy Journal subject: Public Health / Substance-Related Disorders Year: 2022 Document Type: Article