A new study led by researchers at ICES and Unity Health Toronto reveals that both safer opioid supply (SOS) programs and methadone treatments significantly reduce opioid overdoses, healthcare visits, and costs. Published on April 22, 2025, in The Lancet Public Health, the research highlights the complementary roles of these interventions in addressing the opioid crisis, particularly for high-risk individuals.
The study compared health outcomes among 991 individuals newly prescribed SOS and 26,116 starting methadone as opioid agonist treatment (OAT) in Ontario between 2016 and 2021. SOS programs provide pharmaceutical-grade opioids like hydromorphone, offering a safer alternative to unregulated drugs. Researchers found that SOS recipients faced higher rates of HIV, hepatitis C, and prior overdoses, indicating greater medical complexity.
After matching 856 SOS patients with methadone recipients of similar health and demographic profiles, the study observed significant declines in overdoses, emergency department visits, hospitalizations, infections, and healthcare costs in both groups within a year. Deaths were rare in either group.
While methadone recipients had slightly lower risks of overdose and hospitalization, they were more likely to discontinue treatment. After accounting for drop-out rates, the benefits of methadone over SOS diminished, except for slightly lower toxicities.
Dr. Tara Gomes, lead author and scientist at St. Michael’s Hospital, noted, “Neither treatment is a one-size-fits-all solution, but both save lives. Safer supply programs reach those with the highest needs, offering a lifeline when traditional treatments fail.”
The findings underscore the importance of expanding access to both SOS and methadone programs to combat the opioid crisis. By addressing diverse patient needs, these interventions can reduce harms and improve outcomes for vulnerable populations. Future research will explore long-term effects and broader implementation strategies.
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