TUESDAY, Sept. 20, 2022 (HealthDay Information) — As opioid overdose deaths proceed to soar, a Canadian program factors to 1 option to save lives: offering “safer” opioids to individuals at excessive danger of overdose.
That is the conclusion of a examine evaluating Canada’s first formal “safer opioid provide,” or SOS, program. Such applications purpose to stop overdoses by giving weak individuals an alternative choice to the more and more harmful avenue provide of opioids.
On this case, the London, Ontario-based program supplied shoppers with a each day dose of prescription opioid tablets, in addition to primary well being care, counseling and social providers.
The consequence was a fast drop in emergency division journeys and hospitalizations among the many 82 shoppers studied, the researchers discovered. And over six years, there was not a single overdose demise.
“I believe it is a landmark examine,” stated Thomas Kerr, director of analysis on the British Columbia Centre on Substance Use, in Vancouver, Canada.
Kerr, who was not concerned within the examine, acknowledged that SOS applications are controversial and have their critics. Considerations have included the potential for opioid tablets being offered, or individuals crushing the tablets and injecting them, which carries the chance of overdose or an infection.
However criticisms of safer provide have been made within the absence of knowledge, Kerr stated.
“The entire dialog has been clouded by misinformation,” he stated. “Once we’re speaking about issues of life and demise, we will not depend on individuals’s opinions.”
Kerr stated he hoped the brand new findings “will mute among the misinformation.”
The examine was printed Sept. 19 within the CMAJ (Canadian Medical Affiliation Journal). Itcomes amid an ever-worsening opioid epidemic.
In america, opioid overdose deaths have been on the rise for years, and the state of affairs worsened after the pandemic hit. In 2020, practically 92,000 People died of a drug overdose — largely involving opioids, based on the U.S. Facilities for Illness Management and Prevention.
The disaster has primarily been pushed by illegally made variations of the painkiller fentanyl, an artificial opioid that’s 50 occasions stronger than heroin, well being officers say. Illicit fentanyl is offered in varied varieties, together with tablets made to appear like different prescription opioids. It is also generally combined into different unlawful medicine, like cocaine and heroin, to spice up their efficiency. The result’s that customers are sometimes unaware they’re taking fentanyl.
Safer provide applications are primarily based on the precept of hurt discount — that overdoses, infections and different penalties of opioid dependancy may be prevented, with out requiring individuals who misuse medicine to be fully abstinent.
The brand new findings come from a program begun in 2016 at London InterCommunity Well being Centre. It supplies shoppers with hydromorphone (Dilaudid) tablets, distributed each day, in addition to many different providers — together with major well being care, remedy for infections like HIV and hepatitis C, counseling, and assist with housing and different social providers.
The researchers, led by Tara Gomes, of Unity Well being Toronto, checked out knowledge on all 94 shoppers who entered this system between 2016 and March 2019. They in contrast 82 of these individuals towards 303 people identified with opioid dependancy who didn’t participate in this system.
Over one 12 months, the examine discovered, emergency division visits and hospitalizations fell amongst program shoppers, whereas remaining unchanged within the comparability group. And whereas shoppers had medicine prices — coated by Ontario’s prescription drug plan — their yearly well being care prices exterior of major care plunged: from about $15,600, on common, to $7,300.
Once more, there was no substantial change within the comparability group.
Dr. Sandra Springer is an affiliate professor at Yale Faculty of Drugs, in New Haven, Conn., who has helped craft observe tips for the American Society of Dependancy Drugs.
“This examine is additional proof that applications that meet sufferers the place they’re and supply quick access to scientific look after remedy of opioid use dysfunction can save extra lives and scale back well being care prices,” stated Springer, who was not concerned within the analysis.
Opioid dependency itself may be handled with medication-assisted remedy, which includes counseling and drugs like buprenorphine, methadone and naltrexone.
“Whereas this SOS program didn’t present conventional drugs for the remedy of opioid use dysfunction to all individuals, these drugs had been out there to sufferers by means of this system,” Springer famous.
And, she stated, different analysis has proven that when individuals who use medicine are supplied “compassionate care,” they’re extra more likely to settle for “evidence-based remedy.”
The extent to which SOS applications will unfold stays to be seen. In 2020, Well being Canada introduced funding for a number of extra pilot applications. And final 12 months, New York Metropolis opened two overdose prevention websites — the place individuals with opioid dependancy can use the medicine in a clear, supervised setting, and be related with well being care and social providers.
The websites are the primary publicly acknowledged overdose prevention facilities in america.
Kerr stated that within the face of an opioid disaster that’s solely worsening, “the established order response will not be adequate.”
“We have now to strive new approaches,” he stated, “and scientifically consider them.”
The U.S. Nationwide Institute on Drug Abuse has extra on opioid use dysfunction.
SOURCES: Thomas Kerr, PhD, director, analysis, British Columbia Centre on Substance Use, professor, social drugs, College of British Columbia, Vancouver, Canada; Sandra Springer, MD, affiliate professor, drugs, Yale Faculty of Drugs, New Haven, Conn.; CMAJ, Sept. 19, 2022, on-line