Opioid Agonist Therapy: Medication Barriers and Predicting Successful Retention

Canada is currently experiencing an opioid crisis of an unprecedented magnitude. Opioid agonist therapy (OAT) medications are the first-line intervention for opioid use disorder. Despite global efforts to increase retention, only a fraction of individuals with opioid use disorder access OAT, and the majority of those who do drop out of treatment. This mixed method project sought to identify factors that are relevant to OAT retention decisions from the subjective perspectives of individuals utilizing OAT and to test those factors as predicative of successful retention. The qualitative study resulted in fourteen factors that were perceived as influencing retention. A binary logistic regression was conducted and the final model, arrived at through purposeful selection, predicted successful retention over and above the intercept only model. Experiences of stigma, attitudes toward OAT and opioid cravings were found to be significant predictors. Attitudes toward OAT modified the effects of cravings on retention success.