ArticleJAMA network open2025
Retention in Opioid Agonist Therapy Among First Nations People.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- The association between the T allele in rs204076 and treatment retention in patients receiving medication for opioid use disorder.Scientific reports · 2026Article
- Initiation of opioid agonist treatment following hospital-treated opioid toxicities and the risk of repeat events in Ontario, Canada: a cohort study using inverse probability of treatment weights.BMJ public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
Importance: First Nations people are disproportionately impacted by the opioid crisis in Canada. While many First Nation communities have expanded access to treatment, there is a need to better understand the factors associated with early discontinuation of opioid agonist therapies (OAT). Objective: To investigate factors associated with OAT retention within the first year of treatment among First Nations people in Ontario, Canada. Design, Setting, and Participants: This was a population-based retrospective cohort study including all registered (status) First Nations people aged 15 years or older initiating OAT between January 2013 and March 2021. Data were analyzed between October 2022 and June 2024. Exposure: Methadone and buprenorphine-naloxone initiation. Main Outcomes and Measures: The main outcome was duration of OAT treatment, with discontinuation defined as a gap in therapy of more than 14 days. Cox proportional hazards models followed up individuals until the first occurrence of OAT discontinuation, death, end of 1-year follow-up, or switching between OAT treatments. Results: A total of 17 880 OAT initiations among 7476 individuals (median [IQR] age, 31 [26-38] years; 8966 [50.1%] female) were identified, including 9074 new episodes of buprenorphine-naloxone and 8806 new episodes of methadone. Time to treatment discontinuation was shorter among buprenorphine-naloxone episodes (median [IQR], 42 [5-321] days) compared with methadone episodes (median [IQR], 71 [10-544] days) (P < .001). Several factors were associated with buprenorphine-naloxone and methadone retention, including living in moderately sized urban areas (buprenorphine-naloxone: adjusted hazard ratio [aHR], 0.81; 95% CI, 0.70-0.95; methadone: aHR, 0.79; 95% CI, 0.70-0.90) and being recently dispensed non-OAT opioids (buprenorphine-naloxone: aHR, 0.86; 95% CI, 0.80-0.94; methadone: aHR, 0.86; 95% CI, 0.79-0.93). In contrast, factors associated with higher rates of discontinuation included recent opioid toxic events (buprenorphine-naloxone: aHR, 1.36; 95% CI, 1.20-1.54; methadone: aHR, 1.24; 95% CI, 1.11-1.38), and recent methadone treatment (buprenorphine-naloxone: aHR, 1.09; 95% CI, 1.01-1.18; methadone: aHR, 1.67; 95% CI, 1.57-1.78). Methadone discontinuation increased over time; however this pattern was not observed for buprenorphine-naloxone. Conclusions and Relevance: This cohort study among First Nations people found low rates of OAT retention. Although retention was higher for methadone, it declined over time. These findings highlights important gaps in OAT provision for First Nations people that may be improved by investments into First Nations-led treatment programs that integrate traditional, land-based programs to better support people with opioid use disorder across Ontario.
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