B.C. study finds prescribed opioids saved lives

A B.C.-based study published this week shows using prescription-drug replacements for people at risk of overdosing does save lives.

Researchers followed more than 5,800 people with opioid or stimulant-use dependence who filled prescriptions through B.C.’s Risk Mitigation Guidance program for more than a year, between March 2020 and August 2021.

Lead author and BC Centre for Disease Control scientist Dr. Amanda Slaunwhite says the study found people receiving at least a day of prescribed pharmaceutical-grade opioids were 61 per cent less likely to die from any cause within a week than those without, and 55 per cent less likely to die of a drug poisoning or overdose the following week.

“It does show that the guidance that B.C. introduced in March 2020 was effective at reducing death among people who received these medications, which is very encouraging,” she explained.

“Additional research is really needed to understanding those long-term effects and the broader implementation, like who got access to these medications, what were the impacts on other aspects of their lives beyond protections against mortality.”

The study, which was a collaboration between scientists, people with lived experience of substance use, and public health officials from the BCCDC, First Nations Health Authority, and others, “evaluates the effectiveness of Risk Mitigation Guidance.”

“This is the first study to evaluate prescribing pharmaceutical alternatives at a population level. We demonstrated that providing pharmaceutical alternatives to the toxic and unpredictable street drug supply is associated with a reduction in deaths in the days immediately following,” said Slaunwhite, who is also an assistant professor at UBC’s School of Population and Public Health.

“With more than 13,300 lives lost in B.C. since 2016 and one of the highest death rates in the country, we need to identify and evaluate interventions that keep people alive.”

While she notes more research is needed, Premier David Eby says the initial findings are intriguing.

“It certainly confirms what’s intuitive, which is that someone who is dealing with a physician or a nurse practitioner instead of a predatory drug dealer is less likely to die of an overdose,” he said.

“I am certainly very intrigued and interested to review the findings of these researchers.”

Researchers note that the “protective effect” of pharmaceutical alternatives to toxic drugs “increased with the number of days opioid medications were dispensed.” They say those who received four or more days worth of prescription opioids were 91 per cent less likely to die from any cause and 89 per cent less likely to die from overdose in the week following their prescription.

However, those behind the study point out they were not able to assess whether the drugs were used as prescribed or if the person given the prescription used the medication.

The research comes as B.C. continues to lose, on average, seven people a day to toxic drugs.

The latest coroner’s death review panel recommended prescription-free opioids to save lives, though the province saying that’s not an option.