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This study sought to determine the impact of baseline methamphetamine\/amphetamine use on discontinuation of OAT among individuals with prescription\u2010type OUD (POUD) initiating methadone or buprenorphine\/naloxone as part of a pragmatic randomized trial in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary analysis of a pan\u2010Canadian pragmatic trial conducted between 2017 and 2020 comparing supervised methadone versus flexible take\u2010home dosing buprenorphine\/naloxone models of care. Cox proportional hazard models were used to evaluate the effect of baseline methamphetamine\/amphetamine use (measured by urine drug test [UDT]) on two discontinuation outcomes (i.e., assigned OAT discontinuation, any OAT discontinuation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred nine (n\u2009=\u2009209) participants initiated OAT, of which 96 (45.9%) had positive baseline methamphetamine\/amphetamine UDT. Baseline methamphetamine\/amphetamine use was associated with shorter median times in assigned OAT (21 vs. 168 days, hazard ratio [aHR]\u2009=\u20092.45, 95% confidence interval [CI]\u2009=\u20091.60\u20133.76) and any OAT (25 days vs. 168 days, aHR\u2009=\u20092.06, CI\u2009=\u20091.32\u20133.24). No interaction between methamphetamine\/amphetamine and assigned OAT was observed for either outcome (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Scientific Significance<\/jats:title><jats:p>This study offers novel insights on the impact of methamphetamine\/amphetamine use on OAT outcomes among people with POUD. Methamphetamine\/amphetamine use was common and was associated with increased risk of OAT discontinuation. Supplementary interventions, including treatment for stimulant use, are needed to improve retention in OAT and optimize treatment outcomes in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13619","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T12:59:42Z","timestamp":1718456382000},"page":"664-674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of baseline methamphetamine\/amphetamine use on discontinuation of methadone and buprenorphine\/naloxone among people with prescription\u2010type opioid use disorder in Canada"],"prefix":"10.1111","volume":"33","author":[{"given":"Jenna","family":"Langlois","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Fairbairn","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-508X","authenticated-orcid":false,"given":"Didier","family":"Jutras\u2010Aswad","sequence":"additional","affiliation":[{"name":"Research Centre Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CRCHUM) Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine Universit\u00e9 de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"Institute for Mental Health Policy Research Centre for Addiction and Mental Health (CAMH) Toronto Ontario Canada"},{"name":"Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building University of Toronto Toronto Ontario Canada"},{"name":"Addictions Division Centre for Addiction and Mental Health (CAMH) Toronto Ontario Canada"},{"name":"Department of Psychiatry University of Toronto Toronto Ontario Canada"},{"name":"Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health (CAMH) Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Psychiatry, Cumming School of Medicine University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-7049","authenticated-orcid":false,"given":"M. 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