ArticleThe International journal on drug policy2022
Characterizing safer supply prescribing of immediate release hydromorphone for individuals with opioid use disorder across Ontario, Canada.
Article in The International journal on drug policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The trial behind it
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Who cites it
24 citing papers in PubMed, 46 citations in OpenAlex.
- "Safer supply is the thing that changes everything": the role of prescribed safer supply in rebuilding trust following experiences of medical abandonment.BMC public health · 2026Article
- Association between early methadone dose titration and treatment discontinuation and opioid toxicity: A retrospective cohort study.PLoS medicine · 2026Article
- Trends in the dispensing of opioids for pain and concurrent benzodiazepine use among First Nations People in Ontario, Canada, from 2013 to 2021.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- "With this you're not chained down to something": contrasting experiences of opioid agonist treatment and safer supply program participation among people receiving prescribed safer supply.Harm reduction journal · 2026Article
- A sea of need: provider accounts of strategies used to manage admission demands to safer opioid supply programs in Ontario.Harm reduction journal · 2025Article
- "From an HCV and HIV point of view, it's been remarkable": A qualitative study about using prescribed safer supply to support people who use drugs along the HIV and HCV prevention and treatment cascades in Ontario, Canada.Journal of the International AIDS Society · 2025Article
- Clinicians' Perspectives and an Ethical Analysis of Safer Supply Opioid Prescribing.Journal of bioethical inquiry · 2025Article
- Initiation and Dose of Methadone Monotherapy vs Combination Therapy, 2015 to 2023.JAMA network open · 2025Article
- Safer Opioid Supply programs: Hydromorphone prescribing in Ontario as a harm reduction intervention to combat the drug poisoning crisis.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- Opioid medication doses among safer supply clients: Current safer supply doses and previous OAT experience.Drug and alcohol dependence reports · 2025Article
- The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose.The International journal on drug policy · 2025Article
- "It gets you high as a kite but not unsick": Characterizations of and responses to a changing local drug supply by people who use drugs in Rhode Island.The International journal on drug policy · 2024Article
- Prescribed safer supply during dual public health emergencies: a qualitative study examining service providers perspectives on early implementation.Substance abuse treatment, prevention, and policy · 2024Article
- Substance use care innovations during COVID-19: barriers and facilitators to the provision of safer supply at a toronto COVID-19 isolation and recovery site.Harm reduction journal · 2024Article
- Article
- "Safer Drug Supply" Measures in Canada to Reduce the Drug Overdose Fatality Toll: Clarifying Concepts, Practices and Evidence Within a Public Health Intervention Framework.Journal of studies on alcohol and drugs · 2023Article
- Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada.Harm reduction journal · 2023Article
- Disease-related stigma among people who inject drugs in Toronto amidst the COVID-19 pandemic.Drug and alcohol dependence reports · 2023Article
- 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
- Safer opioid supply: qualitative program evaluation.Harm reduction journal · 2023Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundIn response to the ongoing overdose crisis, some clinicians in Canada have started prescribing immediate release hydromorphone (IRH) as an alternative to the toxic unregulated drug supply. This practice is often referred to as safer supply. We aimed to identify and characterize patients receiving safer supply IRH and their prescribers in Ontario.
methodsUsing provincial administrative health data, we identified individuals with opioid use disorder prescribed safer supply IRH from January 2016 to March 2020 and reported the number of initiations over time. We summarized demographic, health, and medication use characteristics among patients who received safer supply IRH, and examined select clinical outcomes including retention and death. Finally, we characterized prescribers of safer supply IRH and compared frequent and infrequent prescribers.
resultsWe identified 534 initiations of safer supply IRH (447 distinct individuals) from 155 prescribers. Initiations increased over time with a peak in the third quarter of 2019 (103 initiations). Patients' median age was 42 (interquartile range [IQR] 34-50), and most were male (60.2%), urban residents, (96.2%), and in the lowest neighborhood income quintile (55.7%), with 13.9% having overdosed in the previous one year. The prevalence of HIV was 13.9%. The median duration on IRH was 272 days (IQR 30-1,244) and OAT was co-prescribed in 62.9% of courses. Death while receiving IRH or within 7 days of discontinuation was rare (≤5 courses;≤0.94 per person-year for each).
conclusionsClinicians are increasingly prescribing safer supply IRH in Ontario. Patients prescribed safer supply IRH had demographic and clinical characteristics associated with high risk of death from opioid-related overdose. Short-term deaths among people receiving safer supply IRH were rare.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.