Opioid overdoses are a public health emergency in North America and internationally. Can a safer supply intervention reduce mortality and acute care visits? New #BMJResearch investigates https://t.co/LugxMspr2G

B.C. study on lives saved by prescribing #opioids a 'watershed moment' in #SaferSupply debate: researcher, by @katiederosayyj https://t.co/qAZJUS3BQw via @VancouverSun @akslaunwhite @Paxbach #HarmReduction

Very proud of all the work that went into this, thanks to everyone that helped contribute to advancing the standard of care for OUD in BC!

The generosity of our donors help support life-changing addiction care and outreach efforts for Road to Recovery at St. Paul's Hospital. Today, we are celebrating West Pender Property Group for their recent $500,000 commitment towards R2R. Learn more at: https://t.co/Q4Vi0nCdug

.@PierrePoilievre is exploiting the drug crisis for political gain and “capitalizing on people’s suffering” by making videos featuring homeless people afflicted by drugs, new Minister of Mental Health and Addictions @YaaraSaks says. https://t.co/702eN798MJ via @globeandmail

*Calling all hospital clinicians caring for people with OUD* (should be all hospital clinicians) If you start methadone in the hospital, two papers just came out that should change the way we do it in the era of fentanyl. Let's talk about hospital-based methadone initiations!!!

May be of specific interest to @DrRuthPotee @_DavidLawrence7 @ZoeWeinstein @DrMeganBuresh @PaulJoudreyMD @MethadoneLib @DrSarahWakeman @DrKimSue @ShadiNahvi @highway_dave

See similar work by @DrMeganBuresh and colleagues below: https://t.co/2RePlhiuEI

To suggest that we continue to use a one-size-fits all approach to methadone titration does a disservice to our patients, and is directly contributing to a greatly decreased impact of the single most promising tool we have. More work is needed, we can do so much better. Fin/

It's worth noting that this doesn't mean such an approach is ready to be adopted widely (esp outside a monitored setting), and the 2 adverse events highlight that caution is warranted and patient selection is key. But the concept of a more nuanced approach is a critical one.

This study describes a rapid methadone titration protocol used in an inpatient setting in Vancouver, Canada. We show that, in an appropriately selected population (95% fentanyl +ve), such titrations can be safe and well tolerated.

So why then do we continue to start at the same dose and increase at the same rates that we have been using for decades prior to the arrival of fentanyl? Why do we know so little about how to factor past treatment and substance use history into an individualized treatment plan?

But, as per most N.A. guidelines, the time that it can take to reach a "therapeutic dose" for those with a higher tolerance is prohibitive (and this is only if clinic attendance is PERFECT, despite 2-3mo on a sub-therapeutic dose with ongoing exposure to a toxic drug supply).

We also know (or at least FEEL pretty strongly) that higher doses of methadone are likely required to effectively treat patients with tolerance to fentanyl, and that these are associated with higher retention rates. https://t.co/21NUnWVHoa

We know that methadone is a powerful tool to help reduce overdose deaths, yet our treatment retention rates are awful (for many reasons, but we will focus here on dosing). This is especially true during the early stages of treatment, before an effective dose is reached.

Despite the devastation of the ongoing overdose crisis, precious little attention has been paid to maximizing the accessibility and impact of the single best-evidenced tool we have to prevent overdose deaths: methadone. (Shout out to @MethadoneLib)

New brief report in @JAM_ASAM: Safety and Efficacy of Rapid Methadone Titration for Opioid Use Disorder in an Inpatient Setting: A Retrospective Cohort Study Why is this topic so very, very important? A thread... https://t.co/0GdTRNC7ir

This is an absolute crisis "In 2015, the ave life expectancy for a First Nation man was 67 – today…[it is] 60. For First Nations women, it’s gone from 73…to 66 years in 2021. The life expectancy of a non-First Nations man is 79. For…women it is 84." https://t.co/D6nKpBycOD

Tonight on A Little More Conversation Corus Radio 7-10pmPT @GidMK WHO to reclassify Aspartame as a possible carcinogen, what does that mean? @Paxbach on tackling the opioid OD crisis @moryan on her book Burn it Down: Power, Complicity, and a Call for Change in Hollywood +more

👉Our new research on the changes in methadone treatment within Canada, Australia and the US during the COVID 19 pandemic #methadone @PittGIM @MethadoneLib https://t.co/X0jPKNptWt