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Management of opioid use disorder: 2024 update to the national clinical practice guideline.
CMAJ
November 2024
Department of Psychology and Neuroscience (Yakovenko, Belliveau, Fraleigh, Stewart); Department of Psychiatry (Yakovenko, Stewart), Dalhousie University, Halifax, NS; Research Centre of Centre Hospitalier de l'Université de Montréal (Mukaneza, Germé), Montréal, Que.; Department of Medicine (Bach, Wood), University of British Columbia; British Columbia Centre on Substance Use (Bach, Wood), Vancouver, BC; Waypoint Centre for Mental Health Care (Poulin); Department of Psychiatry (Poulin), University of Manitoba, Winnipeg, Man.; Addictions Divisions (Selby), Centre for Addition and Mental Health; Dalla Lana School of Public Health (Selby, Rehm), University of Toronto, Toronto, Ont.; Department of Family Medicine and Emergency Medicine (Goyer, Bruneau), Université de Montréal; Centre de recherche et d'aide pour narcomanes (Goyer), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-del'Île-de Montréal, Montréal, Que.; Division of General Internal Medicine (Brothers), Department of Medicine, Dalhousie University, Halifax, NS; Addiction Medicine Consult Service, Mental Health & Addictions Program (Brothers), Nova Scotia Health; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (Rehm), Toronto, Ont.; Department of Psychology (Hodgins), University of Calgary; Department of Psychology (Hodgins), Alberta Gambling Research Institute, Calgary, Alta.; Drug addiction service (Bruneau), Centre Hospitalier de l'Université de Montréal, Montréal, Que.
Article Synopsis
- - The 2024 update of the 2018 National Guideline for Clinical Management of Opioid Use Disorder emphasizes the need for current scientific evidence to inform treatment practices for opioid use disorder in Canada.
- - A comprehensive review from 2017 to 2023 was conducted to revise the guidelines, involving a national committee including those with personal experience in opioid use disorder, and ensuring quality through established methods.
- - Key changes in the recommendations include recognizing methadone and buprenorphine as equally effective first-line treatments, introducing slow-release oral morphine as a second-line option, and highlighting that psychosocial interventions should be optional rather than mandatory.
Neurodevelopmental outcomes in children prenatally exposed to opioid maintenance treatment: A population-based study.
Pharmacotherapy
October 2024
Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA.
Article Synopsis
- The study investigates the long-term effects of opioid maintenance treatment (OMT) during pregnancy, specifically focusing on the impact of methadone and buprenorphine on childhood neurodevelopmental disorders (NDDs).
- Using Rhode Island Medicaid data from 2008-2018, the research looks at pregnancies with opioid use disorder (OUD) and evaluates the timing of drug exposure during gestation.
- Results indicated that children exposed to methadone in early pregnancy had a significantly higher incidence of NDDs (36%) compared to those exposed to buprenorphine (17%), highlighting a potential risk associated with the timing and type of OMT used.
We Need to Talk About Methadone: Adding Discussions With Patients to Our Care Pathways.
Anesth Analg
January 2024
Department of Anesthesiology, Pain and Perioperative Medicine, Brigham and Women's Hospital, Boston, Massachusetts,
Associations between social adversity, caregiver psychological factors, and language outcomes in 9.5-year-old children born to women with opioid use disorder.
Child Neuropsychol
July 2024
School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
We describe the language ability of children at age 9.5 years who were born to women with an opioid use disorder and examine the associations between prenatal opioid exposure, sex, social adversity, caregiver psychological factors, and child language. Data were drawn from the regional prospective longitudinal Canterbury Methadone in Pregnancy study.
View Article and Find Full Text PDFInability to contact opioid agonist therapy prescribers during the COVID-19 pandemic in a Canadian setting: a cross-sectional analysis among people on opioid agonist therapy.
Addict Sci Clin Pract
December 2022
British Columbia Centre on Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Background: The COVID-19 pandemic and consequent public health response may have undermined key responses to the protracted drug poisoning crisis, including reduced access to opioid agonist therapy (OAT) among people with opioid use disorder. Our study objectives were to estimate the prevalence of and identify factors associated with inability to contact OAT prescribers when in need among people on OAT in a Canadian setting during the dual public health crises.
Methods: Survey data were collected from three prospective cohort studies of community-recruited people who use drugs between July and November 2020, in Vancouver, Canada.
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