Predictors of Treatment Outcomes for Patients with Opioid Use Disorder
| dc.contributor.advisor | Samaan, Zainab | |
| dc.contributor.author | Naji, Leen | |
| dc.contributor.department | Health Research Methodology | en_US |
| dc.date.accessioned | 2024-06-19T17:17:11Z | |
| dc.date.available | 2024-06-19T17:17:11Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | Background: Opioid-related mortality rates have steeply risen over the past decade, simultaneous to the increased prevalence of more potent synthetic opioids such as fentanyl in the street drug supply. Many patients with opioid use disorder (OUD) also use cannabis, which has been suggested to reduce opioid use in this population. The purpose of this thesis is to gain a deeper understanding of treatment outcomes for patients with OUD since the onset of the fentanyl era and subsequent legalization of cannabis in Canada, and to evaluate the potential association of cannabis use and treatment outcomes. Methods: We used data from a large sample of patients receiving treatment (methadone or buprenorphine) for OUD from fifty-four clinical sites across Ontario, Canada between 2018 and 2023. We conducted three studies aimed at evaluating various aspects of treatment outcomes for patients with OUD. We specifically focused on the potential implications of cannabis use in these patients. Results: The main conclusions of this work include: 1) although patients on methadone are more likely to stay in treatment than those on buprenorphine, the treatment type did not affect continued non-prescribed opioid use in patients who completed 12-months of follow-up; 2) approximately half of the patients with OUD used cannabis which did not improve treatment outcomes; 3) cannabis use was associated with a heightened propensity for suicidal ideation, irrespective of the frequency of use. Conclusion: We identified several trends associated with response to treatment amongst patients using opioids in the current fentanyl era, and since the legalization of cannabis in Canada. The findings of this thesis are highly generalizable to the typical patient with OUD, and help to identify potentially higher-risk individuals who may benefit from more intensive treatment programs. Future studies are needed to gain a deeper understanding of treatment outcomes for patients with OUD. | en_US |
| dc.description.degree | Doctor of Philosophy (PhD) | en_US |
| dc.description.degreetype | Dissertation | en_US |
| dc.description.layabstract | Many people die from unintentional opioid overdose in North America. Treating patients with opioid addiction is very complicated, and we do not know who benefits most from these treatments. This is because people with opioid addiction often have complex health problems including the use of other drugs, such as cannabis, or medical and psychiatric problems that affect their treatment outcomes. The influence of these factors on patients’ recovery has not been well studied. We therefore conducted three studies aimed to compare the effects of the common treatments for opioid addiction, and explore the role of cannabis use. These studies were done in a large group of patients with opioid addiction. We identified valuable information regarding potential factors that make someone at higher risk of not doing well in treatment, which are important to keep in mind as these individuals may benefit from more intensive treatment programs in addition to medications. | en_US |
| dc.identifier.uri | http://hdl.handle.net/11375/29875 | |
| dc.language.iso | en | en_US |
| dc.title | Predictors of Treatment Outcomes for Patients with Opioid Use Disorder | en_US |
| dc.type | Thesis | en_US |