Correlates of tapering initiation and success at an opioid agonist treatment program in Northern Ontario

Abstract

Currently, there is limited research on the correlates of tapering initiation and success in opioid agonist treatment (OAT). This research is part of a community-based participatory research study conducted in collaboration with a First Nation to describe and identify the benefits and areas of improvement for a community-based OAT program in Wiikwemkoong Unceded Territory. The study utilized retrospective chart review data for all active clients seeking treatment at the community-operated opioid replacement clinic, Naandwe Miikan, between May 2014 and December 2019. The correlates in this study were education level, age, gender, start drug, start dose in morphine equivalent dose (MED), and clients’ number of children. Standard binary logistic regression was used to model the binary variables taper initiation and taper success. Models demonstrated that taper initiation and success were influenced by start dose in MED and start drug, respectively. There were no significant findings related to the sociodemographic correlates. The results from this study have assisted in reducing the substantial gap in knowledge surrounding correlates of taper initiation and taper success in a remote Northern Ontario setting. Findings also identified electronic record limitations that impede robust evidence-based practice at the community level to track the added value of various strengths-based, cultural and community services on clients’ well-being and recovery. Lessons learned identify the need for data sharing agreements across health and mental health services in future research using patient chart data to investigate potential correlates of tapering initiation and success in opioid agonist treatment programs.