ArticleThe International journal on drug policy2017
Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: An interrupted time series analysis.
Article in The International journal on drug policy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- A qualitative study of the impacts of a government crackdown against revenue sharing between pharmacies and patients in Vancouver, Canada.Discover public health · 2026Article
- First-line opioid agonist treatment as prevention against assisting others in initiating injection drug use: A longitudinal cohort study of people who inject drugs in Vancouver, Canada.Drug and alcohol dependence reports · 2023Article
- The Cannabis-Dependent Relationship Between Methadone Treatment Dose and Illicit Opioid Use in a Community-Based Cohort of People Who Use Drugs.Cannabis and cannabinoid research · 2023Article
- Methadone Maintenance Treatment Discontinuation Among Young People who use Opioids in Vancouver, Canada.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2023Article
- Day-to-day impact of COVID-19 and other factors associated with risk of nonfatal overdose among people who use unregulated drugs in five cities in the United States and Canada.Drug and alcohol dependence · 2022Article
- The effect of a methadone reformulation on opioid agonist treatment outcomes: A population-based study in British Columbia, Canada, 2013-14.Journal of substance abuse treatment · 2022Article
- Article
- The relationship between opioid agonist therapy satisfaction and fentanyl exposure in a Canadian setting.Addiction science & clinical practice · 2021Article
- Article
- From methadone to Methadose: Lessons learned from methadone formulation change in British Columbia.Canadian family physician Medecin de famille canadien · 2020Article
- Slow release oral morphine versus methadone for opioid use disorder in the fentanyl era (pRESTO): Protocol for a non-inferiority randomized clinical trial.Contemporary clinical trials · 2020Article
- Trajectories of retention in opioid agonist therapy in a Canadian setting.The International journal on drug policy · 2020Article
- Trajectories of injection drug use among people who use drugs in Vancouver, Canada, 1996-2017: growth mixture modeling using data from prospective cohort studies.Addiction (Abingdon, England) · 2019Article
- Trends in engagement in the cascade of care for opioid use disorder, Vancouver, Canada, 2006-2016.Drug and alcohol dependence · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundIn February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users.
methodsData was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted Time Series Analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrolment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015.
resultsA total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed.
conclusionWe observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies.
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