Alterations in Prescribing of Opioid Agonist Therapy due to the Pandemic (ALT-POP) Study

Even before the COVID-19 pandemic, Canada was going through one of its worst-ever public health crises: the overdose crisis. Unfortunately, the pandemic seems to have further worsened the overdose crisis, with rates of overdose deaths increasing since the pandemic began. The primary medical treatment used to help people stop using illicit opioids is medication to help reduce cravings and prevent overdose. These medications, referred to as opioid agonist therapy, often require clients to go frequently to the pharmacy and their clinic, which makes it more difficult to practice physical distancing to reduce the risk of getting COVID-19. In order to ensure people have access to these life-saving medications during the pandemic, several changes were made to how doctors and nurses provide them in some cases. These changes included less frequent visits to the pharmacy and reduced monitoring such as urine drug tests. While this may make taking the medications easier for some people, it is also important to make sure the changes are safe and do not have any unintended consequences. Our proposal will evaluate how the changes in prescribing of medications for opioid use disorder as a result of COVID-19 impacted the clients who take them. We will use multiple study methods including Ontario-wide administrative health data as well as surveys and interviews with healthcare providers and people with lived expertise related to the use of these medications. The results of this study will be used to decide how to best provide these medications going forward in order to reduce overdose death and treat opioid use disorder during the pandemic, and, in general.