Rates of opioid agonist therapy initiation increasing after hospital visits for opioid toxicity in Ontario, Canada

1. Among individuals receiving care in a hospital setting for opioid toxicity in Ontario, Canada, the proportion who received opioid agonist therapy after discharge increased from 1.7% to 5.6% from 2013 to 2020. 

Evidence Rating Level: 2 (Good)

In this retrospective cohort study, researchers aimed to assess the proportion of patients initiating opioid agonist therapy (OAT), including methadone, buprenorphine-naloxone, or slow-release oral morphine, within 7 days of receiving care in a hospital setting for an opioid overdose. The hospital encounters occurred between 2013 and 2020 in Ontario, Canada. In total, 20,702 hospital visits for opioid toxicity were included in this study. In 2013, OAT initiation was 1.7%. At the end of the study period, in 2020, OAT initiation had risen to 5.6%. Publication of the Canadian Opioid Use Disorder management guideline had no significant impact on the rate of OAT initiation. A limitation of this study is that researchers were unable to collect data on prescriptions for OAT that were administered on discharge but never filled. Overall, this study demonstrates that there are likely a large number of missed opportunities to initiate OAT in hospital settings.

Click to read the study in the CMAJ (Canadian Medical Association Journal)

Image: PD