Admissions to publicly-funded residential treatment for opioid use disorder and opioid toxicity outcomes after discharge in Ontario, Canada: A population-based repeated cross-sectional study
8 affiliations
- 1Ontario Drug Policy Research Network (ODPRN), St. Michael's Hospital Research Institute, Toronto, Ontario, Canada.
- 2St. Michael's Hospital Research Institute, MAP Centre for Urban Health Solutions, Toronto, Ontario, Canada.
- 3ICES, Toronto, Ontario, Canada.
- 4Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
- 5Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
- 6Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
- 7Public Health Ontario, Toronto, Ontario, Canada.
- 8Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Abstract
With Canadian provinces expanding investments for bed-based inpatient (i.e., residential) substance use treatment, it’s important to understand who accesses these programs and their treatment outcomes. Therefore, the aim of our study was to describe admissions to publicly-funded residential treatment for opioid use disorder (OUD) and opioid toxicities rates following discharge. We conducted a population-based repeated cross-sectional study of publicly-funded residential treatment for OUD in Ontario, Canada, between July 1, 2013 and June 30, 2022. We calculated population-adjusted residential treatment admission rates and used joinpoint regression models to assess significant changes in monthly percent changes (MPC). We reported characteristics of discharged clients and weekly rates of fatal or non-fatal opioid toxicity 1-year post-discharge. Among the first identified residential treatment episode for each client, we determined the proportion who had an opioid toxicity event within 28-days post-discharge, overall and stratified by admission date, age, sex, mandated treatment, and discharge reason. Over the study period, admissions fluctuated monthly (from 1.5 [N = 18] to 11.9 [N = 136] per 1,000,000), declining gradually until December 2019 (MPC: -0.3%; p-value = 0.0009) before dropping abruptly between January and April 2020 (MPC: -20.3%; p-value = 0.44) and then rising soon thereafter (MPC, 2.5%; p-value = 0.0001). Overall, 60.8% of clients (N = 9,388; mean age, 33.1 + 10.2 years; 64.1% male) completed their treatment program. Within 28 days post-discharge, 1.4% experienced an opioid toxicity, with higher rates among clients who were male (1.7%), mandated to treatment (2.1%), and discharged early, both voluntarily (2.0%) and involuntarily (2.8%). Despite rising investments into residential treatment programs, our findings showed admissions for OUD dropped substantially early in the COVID-19 pandemic and remained below pre-pandemic levels in the subsequent two years. Importantly, high rates of early discharge and opioid toxicity soon thereafter underscore the need to implement quality standards for residential treatment programs in Ontario and throughout Canada.
Related
- Fall-risk-increasing drug use in older community-dwelling adults: prevalence, association with fall-related admissions and post-discharge prescribing changes-a retrospective cohort study.
- Feasibility and engagement of smartphone delivered yoga imagery with or without personalized avatars in residential substance use treatment: The AT-REACH nonrandomized pilot
- Oral health status and treatment needs of pregnant women attending primary and tertiary healthcare centres of Telangana, India: A population-based cross-sectional study
- Decreasing fentanyl concentrations in urinalysis results for methadone treatment admissions: Evidence of changing fentanyl exposure in street drugs.
- Multidomain residential external exposome and epigenetic ageing in the UK general population
BibTeX
@article{rebic2026admissions,
title = {{Admissions to publicly-funded residential treatment for opioid use disorder and opioid toxicity outcomes after discharge in Ontario, Canada: A population-based repeated cross-sectional study}},
author = {Nevena Rebić and Bisola Hamzat and Daniel McCormack and Paul Kurdyak and Shaleesa Ledlie and Zoë Dodd and Jennifer Wyman and Dana Shearer and Jes Besharah and Charlotte Munro and Jase Watford and Anjie Huang and Pamela Leece and Tara Gomes},
journal = {PLOS Global Public Health},
year = {2026},
month = nov,
doi = {10.1371/journal.pgph.0007566},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007566},
note = {CC BY},
}
RIS
TY - JOUR
TI - Admissions to publicly-funded residential treatment for opioid use disorder and opioid toxicity outcomes after discharge in Ontario, Canada: A population-based repeated cross-sectional study
AU - Nevena Rebić
AU - Bisola Hamzat
AU - Daniel McCormack
AU - Paul Kurdyak
AU - Shaleesa Ledlie
AU - Zoë Dodd
AU - Jennifer Wyman
AU - Dana Shearer
AU - Jes Besharah
AU - Charlotte Munro
AU - Jase Watford
AU - Anjie Huang
AU - Pamela Leece
AU - Tara Gomes
PY - 2026
DA - 2026/11/11
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007566
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007566
AB - With Canadian provinces expanding investments for bed-based inpatient (i.e., residential) substance use treatment, it’s important to understand who accesses these programs and their treatment outcomes. Therefore, the aim of our study was to describe admissions to publicly-funded residential treatment for opioid use disorder (OUD) and opioid toxicities rates following discharge. We conducted a population-based repeated cross-sectional study of publicly-funded residential treatment for OUD in Ontario, Canada, between July 1, 2013 and June 30, 2022. We calculated population-adjusted residential treatment admission rates and used joinpoint regression models to assess significant changes in monthly percent changes (MPC). We reported characteristics of discharged clients and weekly rates of fatal or non-fatal opioid toxicity 1-year post-discharge. Among the first identified residential treatment episode for each client, we determined the proportion who had an opioid toxicity event within 28-days post-discharge, overall and stratified by admission date, age, sex, mandated treatment, and discharge reason. Over the study period, admissions fluctuated monthly (from 1.5 [N = 18] to 11.9 [N = 136] per 1,000,000), declining gradually until December 2019 (MPC: -0.3%; p-value = 0.0009) before dropping abruptly between January and April 2020 (MPC: -20.3%; p-value = 0.44) and then rising soon thereafter (MPC, 2.5%; p-value = 0.0001). Overall, 60.8% of clients (N = 9,388; mean age, 33.1 + 10.2 years; 64.1% male) completed their treatment program. Within 28 days post-discharge, 1.4% experienced an opioid toxicity, with higher rates among clients who were male (1.7%), mandated to treatment (2.1%), and discharged early, both voluntarily (2.0%) and involuntarily (2.8%). Despite rising investments into residential treatment programs, our findings showed admissions for OUD dropped substantially early in the COVID-19 pandemic and remained below pre-pandemic levels in the subsequent two years. Importantly, high rates of early discharge and opioid toxicity soon thereafter underscore the need to implement quality standards for residential treatment programs in Ontario and throughout Canada.
SN - 2767-3375
ER -