North America is currently experiencing a public health crisis due to ongoing opioid overdoses. More than 16,000 people have lost their lives to opioid overdoses between January 2016 and March 2020 in Canada, and British Columbia has the highest rate of opioid-related deaths among other provinces.
Opioid Agonist Treatment (OAT) is a major pillar in the successful treatment of opioid use disorder. The initial stage of OAT is the most critical period of treatment but also poses the highest risk of fatality and treatment drop-out. Patients who are actively using have a high tolerance to opioids and are often undertreated in this phase: during the initiation phase of OAT, intentionally low doses are provided by physicians to reduce adverse reactions and mitigate fatality risk, particularly as many patients are still actively using illicit opioids. These suboptimal doses of OAT result in high rates of drop-out during the initiation phase of treatment and continued use of illicit opioids, increasing the rate of overdose and fatality.
Dr. Martha J Ignaszewski and team, consisting of UBC Professors Glenn Sammis and Dan Bizzotto, as well as principal investigator Dr. Pouya Azar, are developing a portable point-of-care device to quantify opioids in body fluids, including even the most potent fentanyl analogues. This project aims to test this prototype device in a clinical application focusing on the initial treatment phase to create a comprehensive database. With more accurate assessment of pre-existing opioid tolerance, OAT dosage will be able to be initiated at more therapeutically effective doses, reducing delays in provision of life saving treatment, improving retention in care and overall reducing the number of community opioid overdoses.
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