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However, there is limited and conflicting evidence on the impact of cannabis use on OAT outcomes. Given the critical role of retention in OAT in reducing opioid\u2010related morbidity and mortality, we aimed to estimate the association of at least daily cannabis use on the likelihood of retention in treatment among people initiating OAT. As a secondary aim we tested the impacts of less frequent cannabis use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Data were drawn from two community\u2010recruited prospective cohorts of people who use illicit drugs (PWUD). Participants were followed for a median of 81\u00a0months (interquartile range\u00a0=\u00a037\u2013130).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Vancouver, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>This study comprised a total of 820 PWUD (57.8% men, 59.4% of Caucasian ethnicity, 32.2% HIV\u2010positive) initiating OAT between December 1996 and May 2016. The proportion of women was higher among HIV\u2010negative participants, with no other significant differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was retention in OAT, defined as remaining in OAT (methadone or buprenorphine\/naloxone\u2010based) for two consecutive 6\u2010month follow\u2010up periods. The primary explanatory variable was cannabis use (at least daily versus less than daily) during the same 6\u2010month period. Confounders assessed included: socio\u2010demographic characteristics, substance use patterns and social\u2013structural exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In adjusted analysis, at least daily cannabis use was positively associated with retention in OAT [adjusted odds ratio (aOR)\u00a0=\u00a01.21, 95% confidence interval (CI)\u00a0=\u00a01.04\u20131.41]. Our secondary analysis showed that compared with non\u2010cannabis users, at least daily users had increased odds of retention in OAT (aOR\u00a0=\u00a01.20, 95% CI\u00a0=\u00a01.02\u20131.43), but not less than daily users (aOR\u00a0=\u00a01.00, 95% CI\u00a0=\u00a00.87\u20131.14).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among people who use illicit drugs initiating opioid agonist treatment in Vancouver, at least daily cannabis use was associated with approximately 21% greater odds of retention in treatment compared with less than daily consumption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14398","type":"journal-article","created":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T10:28:30Z","timestamp":1537525710000},"page":"2250-2258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["High\u2010intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-7049","authenticated-orcid":false,"given":"Maria Eugenia","family":"Soc\u00edas","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Wood","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4095-8016","authenticated-orcid":false,"given":"Stephanie","family":"Lake","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonaid","family":"Nolan","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Fairbairn","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-2928","authenticated-orcid":false,"given":"Kanna","family":"Hayashi","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hennady P.","family":"Shulha","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seagle","family":"Liu","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-7153","authenticated-orcid":false,"given":"Thomas","family":"Kerr","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3821-6221","authenticated-orcid":false,"given":"M.\u2010J.","family":"Milloy","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver BC Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12551"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.18356\/603a2a94-en"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4355"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.301966"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002207.pub4"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.160554"},{"key":"e_1_2_7_10_1","unstructured":"Harm Reduction International. 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