Determining typical doses of injectable diacetylmorphine and hydromorphone for the treatment of opioid use disorder
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Gonzalez Arreola, Lourdes Atziri
issued: 2022-07-27T16:14:03Z
issued: 2022
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Opioid use disorder (OUD) is a major Public Health concern in Canada. Injectable Opioid Agonist Treatments (iOAT) with diacetylmorphine (DAM) and hydromorphone (HDM) have proven to be safe and effective treatments for OUD. Currently, several sites in British Columbia and across Canada offer iOAT as part of their regular addiction care plan. While effectiveness and safety has been demonstrated, daily program features, such as regular doses, still need to be studied to improve efficiency. Importantly, typical doses of iOAT remain unknown. The aim of this thesis was to determine the most common dosage ranges of iOAT to support program planning. This thesis utilized data from a longitudinal cohort of participants receiving iOAT from August 2014 to April 2020 at the site with the most iOAT clients in Vancouver. Descriptive statistics including interquartile rage and histograms were obtained to illustrate typical doses of iOAT and define dosage groups. Using participants’ data from a double-blind clinical trial, paired t-tests and linear regression were performed to examine differences in double-blind versus open-label iOAT dose received. The open-label potency ratio between DAM and HDM was calculated and described with percentile ranks. A total of 595,305 injections were registered during the study period among 131 participants. Mean DAM doses ranged from 106 – 989 mg per day, with most clients using 150 – 300 mg per session (mean 225 mg) attending 2.7 sessions per day. Mean HDM doses ranged from 51.1 – 696.1 mg per day, the majority using 75 – 150 mg per session (mean 125 mg; 2.8 sessions). A moving average demonstrated that participants’ doses tend to remain stable over the study period. Paired t-test analyses demonstrated that participants received significantly less open-label DAM (-49 mg; p <0.01) but no significant difference in open-label HDM (5 mg; p >0.05). Further testing suggested this difference was attributed to drug preferences. Participants use the entire …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/82205
note: DETERMINING TYPICAL DOSES OF INJECTABLE DIACETYLMORPHINE AND HYDROMORPHONE FOR THE TREATMENT OF OPIOID USE DISORDER by Lourdes Atziri Gonzalez Arreola A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) July 2022 © Lourdes Atziri Gonzalez Arreola, 2022 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Determining typical doses of injectable diacetylmorphine and hydromorphone for the treatment of opioid use disorder submitted by Lourdes Atziri Gonzalez Arreola in partial fulfillment of the requirements for the degree of Master of Science in Population and Public Health Examining Committee: Eugenia Oviedo-Joekes, Professor, School of Population and Public Health, UBC Supervisor Martin T. Schechter, Professor, School of Population and Public Health, UBC Supervisory Committee Member Scott MacDonald, Physician Lead, Providence Crosstown Clinic Supervisory Committee Member Michael Law, Professor, School of Population and Public Health, UBC Additional Examiner iii Abstract Opioid use disorder (OUD) is a major Public Health concern in Canada. Injectable Opioid Agonist Treatments (iOAT) with diacetylmorphine (DAM) and hydromorphone (HDM) have proven to be safe and effective treatments for OUD. Currently, several sites in British Columbia and across Canada offer iOAT as part of their regular addiction care plan. While effectiveness and safety has been demonstrated, daily program features, such as regular doses, still need to be studied to improve efficiency. Importantly, typical doses of iOAT remain unknown. The aim of this thesis was to determine the most common dosage ranges of iOAT to support program planning. This thesis utilized data from a longitudinal cohort of participants receivi…
has type: Thesis/Dissertation
date issued: 2022-11
is shown at: 10.14288/1.0416403
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Oviedo-Joekes, Eugenia
type: Text
identifier URI: http://hdl.handle.net/2429/82205