A population-based matched cohort study

Background
Prescribed safer opioid supply (SOS) programs are novel harm reduction interventions.

Objective
This study examined health outcomes among people receiving SOS over time and relative to a similar group of people receiving methadone.

Methods
We conducted a population-based cohort study among new SOS and methadone recipients in Ontario, Canada, who commenced treatment between Jan 1, 2016 and Dec 31, 2021.

Results
Of 991 new SOS recipients and 25,116 new methadone recipients, 856 individuals from each group were matched. Within-group analysis showed significant improvements among SOS recipients across multiple health outcomes, with similar findings for methadone. In the between-group analysis, SOS recipients had higher hazards of opioid toxicity, emergency visits, and hospitalizations, no difference in infection rates, and were less likely to discontinue treatment. When discontinuation was not censored, differences between groups disappeared for all outcomes except opioid toxicity.

Conclusion
SOS and methadone were associated with improvements in health outcomes, including reduced opioid toxicities and health-care use, in the year after treatment initiation. The findings suggest SOS programs play an important, complementary role to traditional opioid agonist treatment in expanding the options available to support people who use drugs.

Date Released: April 22, 2025