Impact of the COVID-19 pandemic on the prevalence of opioid agonist therapy discontinuation in Ontario, Canada: A population-based time series analysis.
Analgesics, Opioid
/ therapeutic use
Buprenorphine
/ therapeutic use
Buprenorphine, Naloxone Drug Combination
/ therapeutic use
COVID-19
/ epidemiology
Humans
Methadone
/ therapeutic use
Ontario
/ epidemiology
Opiate Substitution Treatment
Opioid-Related Disorders
/ drug therapy
Pandemics
Prevalence
Time Factors
Adherence
COVID-19
Opioid agonist therapy
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 07 2022
01 07 2022
Historique:
received:
25
11
2021
revised:
19
03
2022
accepted:
09
04
2022
pubmed:
1
5
2022
medline:
18
6
2022
entrez:
30
4
2022
Statut:
ppublish
Résumé
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. 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. 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. Trends in the prevalence of OAT discontinuation did not significantly change during the first eight months of the COVID-19 pandemic.
Sections du résumé
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.
Identifiants
pubmed: 35489179
pii: S0376-8716(22)00196-X
doi: 10.1016/j.drugalcdep.2022.109459
pmc: PMC9008980
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Buprenorphine, Naloxone Drug Combination
0
Buprenorphine
40D3SCR4GZ
Methadone
UC6VBE7V1Z
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
109459Subventions
Organisme : CIHR
ID : 153070
Pays : Canada
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.
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