Pharmacological treatment of opioid dependence

Studies have shown that the risk of death in individuals with opioid-use disorder is substantially reduced by the use of opioid agonist treatment.^3,4 The Canadian study outlined on the slide was a retrospective cohort study using several databases across British Columbia, Canada, including patients seen between 1st January 1996 and 30th September 2018.⁴ Individuals receiving opioid agonist treatment were identified based on the presence of ≥1 prescription for an opioid agonist.⁴ The authors recognise that the landscape of opioid abuse changed within the 22-year timeframe of the study, including the proliferation of fentanyl.⁴ Indeed, the presence of illicitly distributed fentanyl and other potent synthetic opioids increased the risk of mortality among individuals with opioid dependence who were not receiving opioid-agonist therapy.⁴

References:
[1] Stotts AL, Dodrill CL, Kosten TR. Opioid dependence treatment: options in pharmacotherapy. Expert Opin Pharmacother 2009; 10 (11): 1727–1740.

[2] Samsó Jofra L, Puig T, Solà I, Trujols J. Interim opioid agonist treatment for opioid addiction: a systematic review. Harm Reduct J 2022; 19 (1): 7.

[3] Santo T Jr, Clark B, Hickman M, et al. Association of opioid agonist treatment with all-cause mortality and specific causes of death among people with opioid dependence: a systematic review and meta-analysis. JAMA Psychiatry 2021; 78 (9): 979–993.

[4] Pearce LA, Min JE, Piske M, et al. Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study. BMJ 2020; 368: m772.