• J Addict Med · Jun 2021

    Supervised Tablet Injectable Opioid Agonist Therapy (TiOAT): A Strategy to Address Safer Supply for Individuals With an Opioid Use Disorder?

    • Jian Weng, Nadia Fairbairn, Christy Sutherland, Cheyenne Johnson, and Seonaid Nolan.
    • British Columbia Centre on Substance Use (BCCSU), Vancouver, BC, Canada (JW, NF, CS, CJ, SN), Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada (NF), Department of Family Practice, University of British Columbia, University Boulevard Vancouver, BC, Canada (CS), School of Nursing, University of British Columbia, Westbrook Mall, Vancouver, BC, Canada (CJ).
    • J Addict Med. 2021 Jun 17.

    AbstractNorth America is in the midst of an overdose crisis, with up to 130 Americans dying daily from a preventable drug overdose. Opioids account for 70% of overdose deaths. Despite government efforts to improve access to opioid use disorder (OUD) treatment and the implementation of various harm reduction initiatives, overdose mortality remains unacceptably high. Although effective treatments exist for OUD (eg, opioid agonist therapies like buprenorphine/naloxone and methadone), many individuals do not achieve stabilization with these medications. Tablet injectable opioid agonist therapy (TiOAT) is an initiative being piloted in British Columbia to provide witnessed access to a safer opioid supply for individuals with treatment-refractory OUD. The program offers participants a safer opioid supply through physician-prescribed pharmaceutical-grade hydromorphone tablets. TiOAT is suitable for individuals with severe OUD who are actively injecting opioids and are refractory to conventional OUD treatment. As such, a scale-up of the TiOAT program may be a feasible alternative to address persistent opioid-related deaths in North America, while minimizing potential harms associated with unwitnessed safer supply opioid prescribing (eg, diversion and overdose). Although a comprehensive evaluation of TiOAT is of critical importance (including an assessment of the program's adverse events), completion of the evaluation should not preclude scale-up of the program in the interim as a strategy to reduce opioid-related harms.Copyright © 2021 American Society of Addiction Medicine.

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