Patterns of methadone maintenance treatment provision in Ontario: Policy success or pendulum excess?

OBJECTIVE

To describe recent trends and patterns in methadone maintenance treatment (MMT) practice regionally and over time in the province of Ontario.

DESIGN

Population-based descriptive study using health administrative data between September 1, 2011, and December 31, 2014.

SETTING

Ontario.

PARTICIPANTS

All active MMT-prescribing physicians and patients receiving MMT in the study period.

MAIN OUTCOME MEASURES: Characteristics of MMT-prescribing physicians, including age, sex, specialty type, practice region, and practice volume; characteristics of patients receiving MMT, including age, sex, neighbourhood income, and region of residence.

RESULTS

Between September 1, 2011, and December 31, 2014, the number of MMT-prescribing physicians and patients who received MMT increased by 26% and 42%, respectively. In 2014, there was a total of 312 MMT-prescribing physicians and 49 703 patients receiving MMT. In 2014 and on a per capita basis, patients receiving MMT were more prevalent in rural regions; and within rural regions, there were disproportionately large numbers of young female MMT patients residing in low-income neighbourhoods.

CONCLUSION

The number of physicians prescribing MMT and patients receiving MMT has increased substantially between 2011 and 2014, with the largest per capita distribution occurring in rural regions and involving young adults. While availability of and access to MMT has improved considerably from before 2000 to levels of high use, these developments are likely influenced by recent trends in the proliferation of prescription opioid misuse across general populations.