Characterising methamphetamine/amphetamine use among opioid agonist therapy-seeking adults with prescription-type opioid use disorder in Canada

Jenna Langlois; Nadia Fairbairn; Didier Jutras-Aswad; Bernard Le Foll; Ron Lim; M Eugenia Socías

doi:10.1111/dar.13863

Characterising methamphetamine/amphetamine use among opioid agonist therapy-seeking adults with prescription-type opioid use disorder in Canada

Drug Alcohol Rev. 2024 May 9. doi: 10.1111/dar.13863. Online ahead of print.

Authors

Jenna Langlois^{1

2}, Nadia Fairbairn^{1

2}, Didier Jutras-Aswad^{3

4}, Bernard Le Foll^{5

6

7

8

9

10

11

12

13}, Ron Lim¹⁴, M Eugenia Socías^{1

2}

Affiliations

¹ British Columbia Centre on Substance Use, Vancouver, Canada.
² Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
³ Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
⁴ Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Canada.
⁵ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
⁶ Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, Toronto, Canada.
⁷ Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada.
⁸ Department of Psychiatry, University of Toronto, Toronto, Canada.
⁹ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
¹⁰ Institute of Medical Sciences, University of Toronto, Toronto, Canada.
¹¹ Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada.
¹² Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
¹³ Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada.
¹⁴ Department of Family Medicine and Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.

PMID: 38721650
DOI: 10.1111/dar.13863

Abstract

Introduction: There has been a significant increase in methamphetamine/amphetamine use in North America, particularly among people who use opioids. Despite its association with several negative health consequences, the population of people who use methamphetamine/amphetamine with opioids is not well characterised. The aim of this study was to investigate correlates of methamphetamine/amphetamine use among adults with prescription-type opioid use disorder (POUD) starting methadone or buprenorphine/naloxone as part of a pragmatic randomised treatment trial in Canada.

Methods: Multivariable logistic regression analyses were used to determine factors associated with baseline methamphetamine/amphetamine use (measured by urine drug test [UDT]) among participants of a pan-Canadian pragmatic trial conducted between 2017 and 2020 comparing supervised methadone versus flexible take-home dosing buprenorphine/naloxone models of care in people with POUD (e.g., licit or illicit, including fentanyl, prescribed or not).

Results: The sample included 269 participants, of which 142 (52.8%) had positive baseline methamphetamine/amphetamine UDT. In the multivariable model, positive fentanyl UDT (adjusted odds ratio [AOR] 13.21, 95% confidence interval [CI] 6.45, 28.30), non-fatal overdose in the last 6 months (AOR 2.26, CI 1.01, 5.17) and a lifetime history of opioid agonist therapy exposure prior to study entry (AOR 2.30, CI 1.09, 4.87) remained positively associated with baseline methamphetamine/amphetamine use.

Discussion and conclusions: In this sample of people with POUD, methamphetamine/amphetamine use was associated with markers of complex and severe OUD, including overdose risk. This suggests the need for targeted interventions to optimise treatment outcomes and prevent future overdoses in this population.

Clinical trial registration: Available at: ClinicalTrials.gov NCT03033732.

Keywords: amphetamine; clinical trial; methamphetamine; opioid agonist therapy; opioid‐related disorders.

Associated data

ClinicalTrials.gov/NCT03033732

Abstract

Associated data

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