Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: Population based retrospective cohort study

BMJPearce LA, Min JE, Piske M, et al. | April 01, 2020

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Researchers undertook this population based retrospective cohort analysis to compare mortality risk in individuals with opioid use disorder on and off opioid agonist treatment (OAT) in a setting with a high prevalence of illicitly manufactured fentanyl and other potent synthetic opioids in the illicit drug supply. This analysis involved 55,347 individuals with opioid use disorder who underwent OAT between 1 January 1996 and 30 September 2018. Follow-up revealed the deaths of 7,030 (12.7%) of 55,347 OAT recipients. Substantially lower all cause standardised mortality ratio was reported on OAT vs off OAT. Overall, among people with opioid use disorder, substantial decreases in the risk of mortality were observed in relation to retention on OAT. A rise in the protective impact of OAT on mortality was evident as fentanyl and other synthetic opioids became common in the illicit drug supply, whereas a high risk of mortality was observed off OAT. As fentanyl becomes more widespread globally, interventions that enhance retention on opioid agonist treatment and prevent recipients from treatment cessation were suggested to be crucial.

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