A recent study published in May in The Lancet has confirmed that Safe Opioid Supply (SOS) serves as an effective treatment tool for opioid use disorder, despite facing significant political backlash. Tara Gomes, PhD, a lead researcher on the team. Their results contribute to the increasing body of evidence proving SOS has advantages over standard opioid agonist therapies (OAT), like methadone.
At first, the study started off with 900 SOS recipients and 25,000 methadone recipients. In addition, we used very strict eligibility criteria to further reduce the sample. This step produced a sample of 856 people from each group, allowing for precise apples-to-apples comparison.
The findings revealed that SOS significantly improved health outcomes for participants. Gomes noted that SOS recipients tend to have more medical needs. All too often, they’re people with a long history of repeated overdoses, with multiple interactions through the healthcare system.
“People who were receiving safer supply were quite complex in terms of high rates of [past] overdoses and health-care interactions and diagnoses [like HIV and hepatitis C] in the years before they started safer supply,” – Tara Gomes.
What surprised them were the quantitative study results which showed both groups seeing remarkable improvements in objectively measured health metrics. These included reductions in opioid toxicities, decreased emergency department visits, fewer hospital admissions, lower rates of new infections, and a decline in deaths attributed to opioid toxicity.
“We found that for both [groups], there were significant improvements across all outcomes that we looked at … [including] reduced opiate toxicities, all-cause emergency department visits, admissions to hospital, new infections … and deaths [from opioid toxicity],” – Tara Gomes.
The most important aspect of the ACT study was its strict control of variables. Gomes made clear that the key to this was making sure that the groups you were comparing were as similar as possible.
“To have a reliable comparison, we needed … to be sure we were comparing apples to apples in terms of the types of people who were starting these programs,” – Tara Gomes.
Andrea Sereda, who runs the SOS program at the London InterCommunity Health Centre. She was especially worried about the current political climate’s effects on access to treatment and other alternatives. She noted that the first SOS program in Canada launched in her facility in 2016, aiming to provide a tailored approach to those struggling with opioid dependency.
Lately, new obstacles have arisen. Funding for most SOS programs ran out in March and has yet to be reauthorized. Without further provincial investment, these at-risk groups will be deprived of the most effective treatment options.
“Right now, it feels as if political parties are really under the sway of public opinion, and that’s not the best way to provide correct therapies and treatments to human beings,” – Andrea Sereda.
In closing, Sereda offered her perspective on how we’re doing with evidence-based medicine these days. She passionately defended the idea that the medical establishment should have the latitude to pursue evidence-based decisions. They mustn’t be afraid of political or public retribution for doing it.
“We’re in a time where evidence-based medicine isn’t being treated with the level of respect [considering the] level of expertise that is involved in it,” – Andrea Sereda.
Gomes emphasized that SOS programs are intended to meet people where they’re at. For the many SOS recipients who don’t want to or aren’t ready to transition to OAT, they face the prospect of losing their services altogether.
“Safer supply programs are in a position right now where they’re trying to adapt and determine if they continue to prescribe safer supply in some way to their patients or if they try to transition those patients to [OAT],” – Tara Gomes.
She ended with a reminder about being actively engaged in the process of treatment. The more time people spend with their care teams, the further away the risk of dying is for them.
“The longer we keep people engaged in treatments, the more likely they are to – No. 1, stay alive,” – Andrea Sereda.
