From Evidence to Impact: IHPME-led Research Shines Light on Benefits of Safer Opioid Supply

A recent study led by IHPME researcher Dr. Tara Gomes sheds light on the role of safer opioid supply (SOS), in addressing the province’s opioid crisis.

By: Marielle Boutin

The study — published in The Lancet Public Health — looks at all Ontarians who started safer opioid supply and a similar group starting methadone treatment between 2016 and 2021. Findings suggested significant health benefits in both groups in the months following, including lower rates of opioid overdose. While those on SOS experienced a higher rate of overdose than those starting methadone, they also found that those on methadone had a higher chance of stopping treatment early, demonstrating the complexity of making direct comparisons of benefits and risks between the two groups.

SOS is a harm reduction approach which provides those at high risk of overdose with a prescribed, pharmaceutical-grade opioid as a safer alternative to toxic street drugs.

According to Dr. Gomes, the study was conducted out of a need to expand our understanding of the safety and effectiveness of safer opioid supply programs. While evidence suggested that SOS programs were providing effective treatment, most of the research was site-specific and did not compare to other possible treatment options.

This study makes the case that SOS plays a valuable role alongside other options like methadone, providing an alternative for those who struggle with traditional treatments and don’t fall into a “one-size-fits-all” approach.

“In my opinion, it is pivotal that we provide people who use substances with options,” says Dr. Gomes. “It is clear from the evidence as well as the lived experience of people who use drugs that the success of different treatment and harm reduction options varies considerably between people and over time.”

Findings from the study reinforced that safer supply programs are engaging those with complex medical needs, such as more severe substance use disorders or frequent drug use, and higher rates of infections such as HIV and Hepatitis C.

By investing in evidence-based treatment and harm reduction programs designed to address the unique needs of Ontario’s diverse population, Dr. Gomes believes governments and healthcare professionals could apply this research to improve patient outcomes and provide better and safer care for those who rely on the unregulated – or illicit – drug supply.

The opioid crisis is one of Ontario’s most pressing public health challenges. According to data from the Public Health Agency of Canada, between 2016 and 2024, approximately 80% of Canada’s nearly 55,000 opioid-related deaths occurred in Ontario. Moreover, regions like Peel and Toronto continue to report an unprecedented number of overdose deaths annually.

Prior studies by Dr. Gomes and others across Canada indicate that many people frequently stop traditional opioid agonist therapies (OAT) like methadone and Suboxone® within the first months of treatment – after which time overdose risk rises quickly. In contrast, this study indicates that people are staying in SOS programs longer which may reflect their focus on accessible, person-centred care for people who often face barriers and discrimination in the healthcare system.

“When we provide an option for people that is low-barrier and designed to meet the described needs of people who use drugs, our study suggests that people will engage in that service, and stay connected to those healthcare providers,” says Dr. Gomes. “This will likely have beneficial impacts on their health beyond simply reducing toxicity risk as this connection with the healthcare system can also help support other healthcare and social needs that can significantly improve people’s quality of life.”

Given the potential for this study to have a significant impact on Ontario’s healthcare system, Dr. Gomes is grateful for her connection to interdisciplinary collaboration at IHPME in her work addressing one of the biggest public health crises in the province.

“I feel very fortunate to be affiliated with IHPME, as this appointment gives me the opportunity to connect and collaborate with colleagues and trainees with vast expertise in research methods, public health, and policy,” says Dr. Gomes. “Conducting research with the goal of informing and evaluating health policy is a core goal of my research team, the Ontario Drug Policy Research Network, and I truly believe that integrating perspectives of the government, clinicians, and people with lived expertise in research – and being intentional and thoughtful in its dissemination – can tangibly impact policy, clinical practice, and the lives of people who are directly impacted by the rapidly shifting policy environment.”