Safer opioid supply program leads to drop in Ontario hospitalizations, ER visits: study
September 21, 2022
By Jessica Smith, The Canadian Press
Sept. 21, 2022, Toronto — Safe opioid supply programs can significantly cut down on emergency department visits and hospitalizations for people at high risk for overdose, new research from Ontario suggests.
A study published Monday in the Canadian Medical Association Journal examined people who used a safer opioid supply program in London, Ont., for just over three years, and found ER visits and hospital admissions had declined one year after participants entered the program.
The study also found no increased risk of infections or overdoses and a decline in health-care costs unrelated to primary care or outpatient medications after a year.
Lead author Tara Gomes, an epidemiologist at Unity Health in Toronto, says the study indicates the London safer opioid supply program is “very safe” and a model that should be applied more broadly to expand harm-reduction options for those at high risk of overdose.
“We found no opioid-related deaths among people who were part of this program in the year after they entered the program,” said Gomes.
“I think it really provides some helpful evidence that these programs can not only be beneficial to people, in terms of just broadly improving their health, but it can also be very safe for them.”
Safer opioid supply programs prescribe pharmaceutical opioids to those at high risk of overdose, as an alternative to an unregulated drug supply.
Researchers behind the study used data from ICES — a non-profit organization based in Toronto that captures, records and anonymizes health records for every doctor or hospital visit in Ontario.
They worked with the London InterCommunity Health Centre, which launched a safer opioid supply program in 2016, using information about enrolments between January 2016 and March 2019 to evaluate the program’s effect on health-care system costs.
Gomes said that approach allowed researchers to evaluate the impact of the London program and how access to a safer drug supply changed predicted outcomes for clients.
She said the study contained two main limitations, the first being that the London health centre combines a safer drug supply site with other health and social services for clients. She says this suggests the program was particularly effective when combined with other types of services.
“What we need to know is, as we look at other safer supply programs that are rolling out, what kinds of services do they provide and do they also have these wraparound services that can be beneficial as well? And can we also evaluate different models that are out there to see what maybe works better?” she said.
Gomes added another limitation of the study was a dearth of information on diversion, saying there are some concerns that people might share drugs from the safer supply with others rather than using them themselves.
“We can’t capture that in the data,” said Gomes. “But what we can say is that ? most of the time, that sharing of their supply is because (clients) are trying to help support their friends, family or people in their community to have access to a known substance that they’re accessing through safer supply. And so it’s really more indicative of the fact that there just isn’t enough safer supply programming out there to support the needs of people.”
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