Negative Impact of Amphetamine-Type Stimulant Use on Opioid Agonist Treatment Retention in Ontario, Canada

Bibliographic Data

ID15523251
AuthorsKristen A Morin (0009-0001-4059-3475, NOSM University), Frank Vojtesek (NOSM University), Shreedhar Acharya (0000-0002-2153-6272, NOSM University), David C Marsh (0000-0002-8769-1785, Health Sciences North, corresponding author)
Year2021
Volume12
Pages782066-782066
Publication date2021-12-20
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2021.782066
PMID34987430
OpenAlexW4200071898
LanguageEN
Citations received2
References cited38

Objective: The objective of this study was to evaluate epidemiological trends of co-use patterns of amphetamine-type stimulants and opioids and the impact of co-use patterns on Opioid Agonist Treatment (OAT) retention in Ontario, Canada. The secondary objective was to assess geographical variation in amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario. Methods: A retrospective cohort study on 32,674 adults receiving OAT from ~70 clinics was conducted between January 1, 2014, and December 31, 2020, in Ontario, Canada. Patients were divided into four groups base on the proportion of positive urine drug screening results for amphetamine-type stimulants during treatment: group 1 (0-25%), group 2 (25-50%), group 3 (50-75%), and groups 4 (75-100%). A Fractional logistic regression model was used to evaluate differences over time in amphetamine-type stimulant use with urine drug screening results. A Cox Proportional Hazard Ratio model was used to calculate the impact of amphetamine-type stimulant use on retention in OAT and adjusted for sociodemographic characteristics, drug use and clinical factors. Lastly, a logistic regression model was used on a subgroup of patients to assess the impact of geography on amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario. Results: There were significant differences in amphetamine-type stimulant positive urine drug screening results year-over-year from 2015 to 2020. Significant differences were observed between amphetamine-type stimulant groups with regards to sociodemographic, clinical and drug use factors. Compared to those with no amphetamine-type stimulant use, the number of days retained in OAT treatment for amphetamine-type stimulant users was reduced (hazard ratio 1.19; 95% confidence interval = 1.07-1.17; p Conclusion: There was a significant increase in amphetamine-type stimulant use among individuals in OAT from 2014 to 2020, associated with decreased OAT retention. Research is required to determine if tailored strategies specific to individuals in OAT who use amphetamine-type stimulants can improve OAT outcomes

Agonist · Amphetamine · Anesthesia · Dextroamphetamine · Dopamine · Opioid · Opioid epidemic · Opioid-Related Disorders · Psychiatry · Receptor · Stimulant · Medicine · Neurotransmitter Receptor Influence on Behavior · Opioid Use Disorder Treatment · Psychology · Substance Abuse Treatment and Outcomes · Internal Medicine · Pharmacology

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