{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T10:30:46Z","timestamp":1777804246964,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T00:00:00Z","timestamp":1628035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FRN# 171259"],"award-info":[{"award-number":["FRN# 171259"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R25DA033211"],"award-info":[{"award-number":["R25DA033211"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Buprenorphine and methadone are highly effective first\u2010line medications for opioid agonist treatment (OAT) but are not acceptable to all patients. We aimed to assess the uptake of slow\u2010release oral morphine (SROM) as second\u2010line OAT among medically ill, hospitalised patients with opioid use disorder who declined buprenorphine and methadone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included consecutive hospitalised patients with untreated moderate\u2010to\u2010severe opioid use disorder referred to an inpatient addiction medicine consultation service, between June 2018 and September 2019, in Nova Scotia, Canada. We assessed the proportion of patients initiating first\u2010line OAT (buprenorphine or methadone) in\u2010hospital, and the proportion initiating SROM after declining first\u2010line OAT. We compared rates of outpatient OAT continuation (i.e., filling outpatient OAT prescription or attending first outpatient OAT clinic visit) by medication type, and compared OAT selection between patients with and without chronic pain, using \u03c7<jats:sup>2<\/jats:sup> tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four patients were offered OAT initiation in\u2010hospital; six patients (18%) also had chronic pain. Twenty\u2010one patients (62%) initiated first\u2010line OAT with buprenorphine or methadone. Of the 13 patients who declined first\u2010line OAT, seven (54%) initiated second\u2010line OAT with SROM in\u2010hospital. Rates of outpatient OAT continuation after hospital discharge were high (&gt;80%) and did not differ between medications (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.4). Patients with co\u2010existing chronic pain were more likely to choose SROM over buprenorphine or methadone (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>The ability to offer SROM (in addition to buprenorphine or methadone) increased rates of OAT initiation among hospitalised patients. Increasing access to SROM would help narrow the opioid use disorder treatment gap of unmet need.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13365","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T14:13:39Z","timestamp":1628086419000},"page":"430-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Uptake of slow\u2010release oral morphine as opioid agonist treatment among hospitalised patients with opioid use disorder"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-5556","authenticated-orcid":false,"given":"Thomas D.","family":"Brothers","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Dalhousie University  Halifax Canada"},{"name":"UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Fraser","sequence":"additional","affiliation":[{"name":"Mobile Outreach Street Health North End Community Health Centre  Halifax Canada"},{"name":"Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine Dalhousie University  Halifax Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-2860","authenticated-orcid":false,"given":"Emily","family":"MacAdam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Dalhousie University  Halifax Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine Dalhousie University  Halifax Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7692-7150","authenticated-orcid":false,"given":"Duncan","family":"Webster","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Dalhousie University  Halifax Canada"},{"name":"Division of Infectious Diseases Saint John Regional Hospital  Saint John Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6911a4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1346"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2020.05.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw157"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.16228"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa062"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy924"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CXA.0000000000000080"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.202124"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2020.1856291"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05966-0"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-019-00267-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-2373"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05920-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170958"},{"key":"e_1_2_8_18_1","unstructured":"Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working GroupDrug misuse and dependence: UK guidelines on clinical management [Internet]. 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