Optimizing care for opioid use disorder in British Columbia

British Columbia is facing an unprecedented and escalating opioid crisis, underscoring the urgent need for innovative science-driven solutions. There is critical implementation gap of evidence-based care for opioid use disorder (OUD), this research will seek to narrow this gap.

First, Dr. Socias will seek to advance the implementation of evidence-base treatments for OUD, by leading a series of ongoing and planned clinical trials evaluating innovative and promising models of care (e.g. take-home strategies) and alternate treatment options (e.g. slow-release oral morphine).

Second, leveraging vast data from two long-standing cohort studies of over 3,000 people who use drugs, she will apply innovative quality metrics (i.e., cascade of care framework) to evaluate the impacts of addiction health system implementation efforts in BC over time. Identifying individual-, social- and structural-level facilitators and barriers to uptake and effectiveness of novel interventions, as well as to how these new addiction programs may impact health care access and outcomes of OUD care and related comorbidities (e.g. HIV, hepatitis C) will be key to informing efforts to improve the delivery of addiction care in BC.

End of Award Update – April 2024

Results

Findings from the OPTIMA trial showed that more flexible approaches to opioid use disorder care are similarly effective than more traditional approaches requiring people to go to the pharmacy every day. This has important clinical and policy implications as there is substantial evidence, including from my own research, that rigid models of care are one of the main barriers to retention in treatment, and that discontinuation from treatment increase the risk of overdose and death. We are now evaluating the effectiveness of novel pharmacotherapies in real-world settings.

Impact

Findings from my research have informed clinical guidelines, and policy decisions (re-introduction of methadone formulation in the OAT program in BC).

Potential Influence

I expect that findings from my research evaluating slow-release morphine will have implications to better understand its benefits and risks in the continuum of care of opioid use disorder.

Next Steps

I will continue with research to close the implementation gap in substance use care, including opioid use disorder, but also using some of the learnings to address alcohol use, which has a substantial burden of disease.