Grant: Operating Grant: Data Analysis Using Existing CDN Databases and Cohorts

Opioid overdoses are increasing among youth in Canada. In British Columbia, illicit drug overdoses are the leading cause of death among individuals ages 10 to 18. In Ontario, rates of opioid overdose death among individuals ages 15 to 24 increased nearly five-fold from 2013 to 2021. Across Canada, deaths from opioid overdoses among individuals under age 30 nearly tripled between 2016 and 2021. Providing optimal opioid use disorder treatment to youth is necessary to reverse these concerning trends. Despite increasing rates of opioid-related harms among youth, there is limited youth-specific data to guide treatment recommendations for this age group, and most treatment recommendations are made with data from studies in adults. Youth with opioid use disorder differ in important ways from adults with opioid use disorder, and high-quality, youth-specific data is necessary to ensure that youth are receiving optimal treatments. In this study, we will use population-wide administrative claims data to emulate a randomized controlled trial comparing methadone and buprenorphine-naloxone among Ontario youth with opioid use disorder. This design will allow us to study outcomes among youth who are often excluded from clinical trials, ensuring that the results will be generalizable. We anticipate that these results will help inform the development of youth-specific opioid use disorder treatment guidelines.