The OPTIMA Study

Did you know that more than 32,500 Canadians died from opioid intoxication between January 2016 and June 2022? Or that more than 350,000 people who used drugs containing opioids to relieve their pain did so problematically? Today, Canada is among the world’s top consumers of opioids, whether they’re medically prescribed or obtained illegally from illicit producers of very powerful substances such as fentanyl.

From 2017-2020, researchers with the Canadian Research Initiative on Substance Misuse (CRISM) launched OPTIMA - a clinical trial aimed at investigating a more flexible model of care than methadone to treat opioid use disorder. Rather than methadone, which has to be taken under close supervision at a pharmacy, their model of care is based on prescribing buprenorphine-naloxone, known commercially as Suboxone.

Participants in the study were allowed to take buprenorphine-naloxone at home starting in their first weeks of treatment. The approach proved just as effective as using methadone, without the need for close supervision. So what does this tell us? It tells us that offering patients flexibility in their care works just as well as supervised methods in reducing opioid use.

Now what? We need to consider how we can provide Canadians with more flexible treatment options for OUD beyond buprenorphine with naloxone. This means moving away from traditional rigid methods of delivering OUD treatments and creating models of care that better suit people’s needs, situations and promote autonomy.