{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:02:15Z","timestamp":1777521735194,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIS-144301, CIS-144302, CIS-144303, CIS-144304"],"award-info":[{"award-number":["CIS-144301, CIS-144302, CIS-144303, CIS-144304"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["SMN-139148, SMN-139149, SMN-139150, SMN-139151"],"award-info":[{"award-number":["SMN-139148, SMN-139149, SMN-139150, SMN-139151"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There is limited evidence on how opioid agonist treatment (OAT) may affect psychoactive non-opioid substance use in prescription-type opioid use disorder (POUD) and whether this effect might explain OAT outcomes. We aimed to assess the effect of methadone on non-opioid substance use compared to buprenorphine\/naloxone (BUP\/NX), to explore whether non-opioid substance use is associated with opioid use and retention in treatment, and to test non-opioid use as a moderator of associations between methadone with retention in OAT and opioid use compared to BUP\/NX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a secondary analysis of data from the OPTIMA trial, an open-label, pragmatic, parallel, two-arm, pan-Canadian, multicentre, randomized-controlled trial to compare standard methadone model of care and flexible take-home dosing BUP\/NX for POUD treatment. We studied the effect of methadone and BUP\/NX on non-opioid substance use evaluated by urine drug screen (UDS) and by classes of non-opioid substances (i.e., tetrahydrocannabinol [THC], benzodiazepines, stimulants) (weeks 2\u201324) using adjusted generalized estimation equation (GEE). We studied the association between non-opioid substance-positive UDS and opioid-positive UDS and retention in treatment, using adjusted GEE and logistic regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, methadone was not associated with non-opioid substance-positive UDS compared to BUP\/NX (OR: 0.78; 95%CI, 0.41 to 1.48). When non-opioid substances were studied separately, methadone was associated with lower odds of benzodiazepine-positive UDS (OR: 0.63; 95% CI: 0.40 to 0.98) and THC-positive UDS (OR: 0.47; 95% CI: 0.28 to 0.77), but not with different odds of stimulant-positive UDS (OR: 1.29; 95% CI: 0.78 to 2.16) compared to BUP\/NX. Substance-positive UDS, overall and separate classes, were not associated with opioid-positive UDS or retention in treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Methadone did not show a significant effect on overall non-opioid substance use in POUD compared to BUP\/NX treatment but was associated with lower odds of benzodiazepine and THC use in particular. Non-opioid substance use did not predict OAT outcomes. Further research is needed to ascertain whether specific patterns of polysubstance use (quantity and frequency) may affect treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437231210796","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T04:03:27Z","timestamp":1698638607000},"page":"252-263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Buprenorphine\\Naloxone and Methadone Treatment and non-Opioid Substance Use in Prescription-Type Opioid Use Disorder: Secondary Analyses From the OPTIMA Study: Associations entre le traitement avec la bupr\u00e9norphine\/naloxone et avec la m\u00e9thadone et l'utilisation de substances non opio\u00efdes dans le trouble li\u00e9 \u00e0 l'usage d'opio\u00efdes de type sur ordonnance : analyses secondaires de l'\u00e9tude OPTIMA"],"prefix":"10.1177","volume":"69","author":[{"given":"Hamzah","family":"Bakouni","sequence":"first","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidar","family":"Sharafi","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Drouin","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphaelle","family":"Fortin","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Marsan","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Brissette","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Eugenia","family":"Socias","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use"},{"name":"University of British Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Lim","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-508X","authenticated-orcid":false,"given":"Didier","family":"Jutras-Aswad","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM)"},{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_3_2_3_2","unstructured":"Statistics Canada. 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