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Prescribed safer opioid supply: A scoping review of the evidence.
- Source :
-
International Journal of Drug Policy . Mar2024, Vol. 125, pN.PAG-N.PAG. 1p. - Publication Year :
- 2024
-
Abstract
- • Prescribed safer opioid supply programs continue to expand across Canada. • We conducted a scoping review of client outcomes and client/provider perceptions. • Generally, program participation is associated with beneficial client outcomes. • Large population level studies are required to study rarer outcomes and diversion. • More research is needed for program adaption and to address unique regional needs. Safer opioid supply programs provide prescription pharmaceutical opioids, often with supportive services, to people at high risk of experiencing harms related to substance use. However, questions regarding the effectiveness and safety of this practice remain. We conducted a scoping review of literature describing client outcomes from formal opioid supply programs providing prescriptions for pharmaceutical opioids, and the perceptions of involved clients/providers. We performed a scoping review of peer-reviewed studies and grey literature published between January 1, 2012, to September 12, 2023. We included articles reporting either safer opioid supply client outcomes or clients/providers perspectives. Extracted data included study objectives, substance use patterns, client outcomes, client/provider perspectives, and estimates of effectiveness and/or harm. Our search yielded 1,597 articles. Following removal of duplicates and application of exclusion criteria, 24 publications comprising 17 peer-reviewed and seven grey literature publications were included in our study. We generated eight themes summarizing topics in the available literature: opioid-related toxicities, infectious complications, other clinical outcomes, client-reported outcomes, program access barriers, diversion, program retention, and costs to the healthcare system. Specific findings included low rates of opioid toxicities, improved physical and mental health, and improved quality of life among clients. A lack of access to adequate opioid doses and the limited range of opioid options offered within safer opioid supply programs was described by clients and providers as a potential reason for diversion and a barrier to program access. Generally, evidence suggests that safer opioid supply programs are beneficial to clients through measurable outcomes. However, the available literature has important limitations, including limited inferences about the effectiveness, safety, and potential for diversion within safer opioid supply programs. Further research is needed to support the ongoing evaluation of safer opioid supply programs as one component of a multifactorial response to escalating rates of substance-related harms. [ABSTRACT FROM AUTHOR]
- Subjects :
- *SUBSTANCE abuse risk factors
*RISK assessment
*HEALTH services accessibility
*DRUG toxicity
*PATIENT safety
*MENTAL health
*TREATMENT effectiveness
*SYSTEMATIC reviews
*THEMATIC analysis
*OPIOID analgesics
*ATTITUDES of medical personnel
*LITERATURE reviews
*PHYSICIAN practice patterns
*QUALITY of life
*DRUGS
*SOCIAL support
*DRUG prescribing
*HEALTH outcome assessment
*PATIENTS' attitudes
*MEDICAL care costs
Subjects
Details
- Language :
- English
- ISSN :
- 09553959
- Volume :
- 125
- Database :
- Academic Search Index
- Journal :
- International Journal of Drug Policy
- Publication Type :
- Academic Journal
- Accession number :
- 176631339
- Full Text :
- https://doi.org/10.1016/j.drugpo.2024.104339