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Impact of the COVID-19 pandemic on the prevalence of opioid agonist therapy discontinuation in Ontario, Canada: A population-based time series analysis.
Garg, Ria; Kitchen, Sophie A; Men, Siyu; Campbell, Tonya J; Bozinoff, Nikki; Tadrous, Mina; Antoniou, Tony; Wyman, Jennifer; Werb, Dan; Munro, Charlotte; Gomes, Tara.
  • Garg R; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
  • Kitchen SA; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada.
  • Men S; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada.
  • Campbell TJ; Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada.
  • Bozinoff N; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, Ontario M5G 1V7, Canada.
  • Tadrous M; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario M5S 3M2, Canada; Women's College Hospital, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada.
  • Antoniou T; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, On
  • Wyman J; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario M5S 3M2, Canada; Women's College Hospital, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada.
  • Werb D; Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada; Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Division of Infectious Diseases & Global Public Health at the University
  • Munro C; Ontario Drug Policy Research Network Lived Experience Advisory Group, Canada.
  • Gomes T; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario M5S 3M2, Ca
Drug Alcohol Depend ; 236: 109459, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1850939
ABSTRACT

BACKGROUND:

We assessed the impact of COVID-19, which includes the declaration of a state of emergency and subsequent release of pandemic-specific OAT guidance (March 17, 2020 to March 23, 2020) on the prevalence of OAT discontinuation.

METHODS:

We conducted a population-based time series analysis using interventional autoregressive integrated moving average models among Ontario residents who were stable (>60 days of continuous use) and not yet stable on OAT. Specifically, we examined whether COVID-19 impacted the weekly percentage of individuals who discontinued OAT, overall and stratified by treatment type (methadone vs. buprenorphine/naloxone). Additionally, we compared demographic characteristics and patient outcomes among people stable on OAT who discontinued treatment during (March 17, 2020 to November 30, 2020) and prior (July 3, 2019 to March 16, 2020) to the pandemic.

RESULTS:

The weekly prevalence of OAT discontinuation across the study period ranged between 0.6% and 1.1%, among those stable on treatment compared to 7.3% and 16.6%, among those not stable on treatment. Following COVID-19, there was no significant change in the percentage of Ontarians who discontinued OAT, regardless of whether they were stabilized on treatment. Among those stable on OAT, a similar proportion of patients restarted therapy and experienced opioid-related harm following an OAT discontinuation. However, mortality following OAT discontinuation must be noted, as approximately 1.4% and 0.8% of people who discontinued methadone and buprenorphine/naloxone respectively, died within 30 days of discontinuation.

CONCLUSIONS:

Trends in the prevalence of OAT discontinuation did not significantly change during the first eight months of the COVID-19 pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article Affiliation country: J.drugalcdep.2022.109459

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Buprenorphine / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study Limits: Humans Country/Region as subject: North America Language: English Journal: Drug Alcohol Depend Year: 2022 Document Type: Article Affiliation country: J.drugalcdep.2022.109459