Grant: Travel Awards - Institute Community Support

Opioid addiction is a major public health issue in Canada and around the world. Many people living with opioid addiction use medications such as methadone, buprenorphine, or naltrexone to reduce cravings, prevent relapse, and support recovery. However, there are several medication options available, and it is not always clear which ones work best or are safest for long-term use. Our study looked at more than 100 clinical trials involving over 26,000 people with opioid addiction who received one or more of 13 different medications. We combined all the available evidence using a method called network meta-analysis, which lets researchers compare many treatments at once, even when they were tested in separate trials. We found that heroin-assisted therapy (used only for people who were already dependent on heroin), alone or combined with methadone, and high-dose methadone were the most effective for helping people stay in treatment. Buprenorphine and high-dose methadone also helped more people remain abstinent from opioids. However, no treatment clearly reduced overdose or death, and most studies did not include people who use fentanyl, which is now common in Canada's toxic drug supply. These findings help show which treatments are most effective and where important gaps remain. More research is needed on newer patterns of opioid use and on how these medications can be used safely in today's drug environment. Our work supports better evidence for doctors, policymakers, and health systems to make informed decisions about opioid addiction treatment and improve outcomes for people affected by this crisis.