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This study examined characteristics associated with OAT engagement\u2014never, previous or current\u2014among people with opioid dependence in NSW, Australia, following recent reforms to OAT access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between October 2023 and March 2024, people with opioid dependence were recruited from services and community settings across NSW. Participants completed structured interviews on socio\u2010demographics, mental health disorders, substance use and use of prevention and treatment services. Logistic regression was used to examine associations between participant characteristics and engagement with OAT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 403 participants (mean age 44; 65% male), 77% were currently receiving OAT (60% methadone, 11% sublingual buprenorphine and 27% long\u2010acting injectable buprenorphine), 13% previously and 9% never. Differences between OAT status groups included those currently receiving OAT reporting lower rates of homelessness and extra\u2010medical opioid use,\u00a0and\u00a0greater group therapy engagement and past\u2010year receipt of naloxone kits compared to those previously and never receiving OAT. Past\u2010month daily injecting drug use was higher among those previously and never receiving OAT; those previously receiving OAT also reported the highest rate of past\u2010year supervised injecting facility use and overdoses in the past 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>\n                      Those not receiving\n                      <jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content>\n                      reported greater social instability, recent injecting drug use and drug\u2010related harm. Variation in harm reduction service use suggests tailored strategies are needed to reach those outside\n                      <jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content>\n                      . These findings highlight the need for integrated, diverse strategies to address dependence\u2010related harms.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70132","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:42:50Z","timestamp":1773841370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated With Opioid Agonist Treatment Engagement and Harm Reduction Service Use: Findings From the New South Wales Opioid Dependence Survey"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1218-3946","authenticated-orcid":false,"suffix":"Jr","given":"Thomas","family":"Santo","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9778-0386","authenticated-orcid":false,"given":"Chrianna","family":"Bharat","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Alcohol and Drug Services, St Vincent's Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8763-3115","authenticated-orcid":false,"given":"Mary","family":"Harrod","sequence":"additional","affiliation":[{"name":"The NSW Users and AIDS Association  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4676-3233","authenticated-orcid":false,"given":"Sophia","family":"Taylor","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6646-1633","authenticated-orcid":false,"given":"Emma","family":"Zahra","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-1751","authenticated-orcid":false,"given":"Rachel","family":"Sutherland","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2026","authenticated-orcid":false,"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"School of Psychology University of Tasmania  Hobart Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1833-2017","authenticated-orcid":false,"given":"Jason","family":"Grebely","sequence":"additional","affiliation":[{"name":"The\u00a0Kirby\u00a0Institute UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Population Health Science, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-2218","authenticated-orcid":false,"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32229-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109551"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.102656"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.109851"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.4170"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_2_10_8_1","unstructured":"S.Whetton R. 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