Saving Lives With 'Safer Opioids'

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By Amy Norton        
       HealthDay Reporter

TUESDAY, Sept. 20, 2022 (HealthDay News) -- As opioid overdose deaths proceed to soar, a Canadian programme points to 1 mode to prevention lives: providing "safer" opioids to radical astatine precocious hazard of overdose.

That's the decision of a survey evaluating Canada's archetypal ceremonial "safer opioid supply," oregon SOS, program. Such programs purpose to forestall overdoses by giving susceptible radical an alternate to the progressively unsafe thoroughfare proviso of opioids.

In this case, the London, Ontario-based programme provided clients with a regular dose of medicine opioid tablets, arsenic good arsenic basal wellness care, counseling and societal services.

The effect was a accelerated driblet successful exigency section trips and hospitalizations among the 82 clients studied, the researchers found. And implicit six years, determination was not a azygous overdose death.

"I deliberation this is simply a landmark study," said Thomas Kerr, manager of probe astatine the British Columbia Centre connected Substance Use, successful Vancouver, Canada.

Kerr, who was not progressive successful the study, acknowledged that SOS programs are arguable and person their critics. Concerns person included the anticipation of opioid pills being sold, oregon radical crushing the tablets and injecting them, which carries the hazard of overdose oregon infection.

But criticisms of safer proviso person been made successful the lack of data, Kerr said.

"The full speech has been clouded by misinformation," helium said. "When we're talking astir matters of beingness and death, we can't trust connected people's opinions."

Kerr said helium hoped the caller findings "will mute immoderate of the misinformation."

The survey was published Sept. 19 successful the CMAJ (Canadian Medical Association Journal). Itcomes amid an ever-worsening opioid epidemic.

In the United States, opioid overdose deaths person been connected the emergence for years, and the concern worsened aft the pandemic hit. In 2020, astir 92,000 Americans died of a cause overdose — mostly involving opioids, according to the U.S. Centers for Disease Control and Prevention.

The situation has chiefly been driven by illegally made versions of the painkiller fentanyl, a synthetic opioid that is 50 times much potent than heroin, wellness officials say. Illicit fentanyl is sold successful assorted forms, including pills made to look similar different medicine opioids. It's besides commonly mixed into different amerciable drugs, similar cocaine and heroin, to boost their potency. The effect is that users are often unaware they're taking fentanyl.

Safer proviso programs are based connected the rule of harm simplification — that overdoses, infections and different consequences of opioid addiction tin beryllium prevented, without requiring radical who misuse drugs to beryllium wholly abstinent.

The caller findings travel from a programme begun successful 2016 astatine London InterCommunity Health Centre. It provides clients with hydromorphone (Dilaudid) tablets, dispensed daily, arsenic good arsenic galore different services — including superior wellness care, attraction for infections similar HIV and hepatitis C, counseling, and assistance with lodging and different societal services.

The researchers, led by Tara Gomes, of Unity Health Toronto, looked astatine information connected each 94 clients who entered the programme betwixt 2016 and March 2019. They compared 82 of those radical against 303 individuals diagnosed with opioid addiction who did not instrumentality portion successful the program.

Over 1 year, the survey found, exigency section visits and hospitalizations fell among programme clients, portion remaining unchanged successful the examination group. And portion clients had medicine costs — covered by Ontario's medicine cause program — their yearly wellness attraction costs extracurricular of superior attraction plunged: from astir $15,600, connected average, to $7,300.

Again, determination was nary important alteration successful the examination group.

Dr. Sandra Springer is an subordinate prof astatine Yale School of Medicine, successful New Haven, Conn., who has helped trade signifier guidelines for the American Society of Addiction Medicine.

"This survey is further grounds that programs that conscionable patients wherever they are and supply casual entree to objective attraction for attraction of opioid usage upset tin prevention much lives and trim wellness attraction costs," said Springer, who was not progressive successful the research.

Opioid dependency itself tin beryllium treated with medication-assisted therapy, which involves counseling and medications similar buprenorphine, methadone and naltrexone.

"While this SOS programme did not supply accepted medications for the attraction of opioid usage upset to each participants, those medications were disposable to patients done the program," Springer noted.

And, she said, different probe has shown that erstwhile radical who usage drugs are offered "compassionate care," they are much apt to judge "evidence-based treatment."

The grade to which SOS programs volition dispersed remains to beryllium seen. In 2020, Health Canada announced backing for respective further aviator programs. And past year, New York City opened 2 overdose prevention sites — wherever radical with opioid addiction tin usage the drugs successful a clean, supervised setting, and beryllium connected with wellness attraction and societal services.

The sites are the archetypal publically recognized overdose prevention centers successful the United States.

Kerr said that successful the look of an opioid situation that is lone worsening, "the presumption quo effect is not sufficient."

"We person to effort caller approaches," helium said, "and scientifically measure them."

         
         More information        

The U.S. National Institute connected Drug Abuse has much connected opioid usage disorder.

SOURCES: Thomas Kerr, PhD, director, research, British Columbia Centre connected Substance Use, professor, societal medicine, University of British Columbia, Vancouver, Canada; Sandra Springer, MD, subordinate professor, medicine, Yale School of Medicine, New Haven, Conn.; CMAJ, Sept. 19, 2022, online