Examining Differences Among Opioid Agonist Treatment Clients in Regional and Metropolitan Settings of New South Wales, Australia.
Daniel T Winter, Lauren A Monds, Nicholas Lintzeris and 2 others
PMID 40105272WHAT IT FOUND
Regional OAT clients were more likely to use buprenorphine and private dosing sites, and to travel by car or active transport rather than public transport.
They reported less past-month heroin, but driving offences mostly did not differ.
Key findings
01Regional OAT clients were more likely to be prescribed buprenorphine (45.6% versus 25.9% of metropolitan clients) and to obtain medication from private dosing sites (45.6% versus 4.7%).
02Regional clients were more likely to travel to dosing by motor vehicle (61.4% versus 37.7%) or active transport, and less likely to use public transport (11.7% versus 49.6%).
03Regional clients reported less past-month heroin use (7.8% versus 22.2%), while reported driving offences and driving under the influence did not differ by region.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample of clients attending public drug and alcohol clinics, and response rates at each clinic site were unknown. Data were self-reported and collected verbally during COVID-19 restrictions, so social desirability bias, recall bias and changing transport patterns may affect the results. Most regional participants were from Inner Regional NSW, with few from Outer Regional or Remote areas and none from Very Remote areas, so findings may not apply to more remote locations. The survey did not ask about dosing schedules or reasons for medication choice, so the study cannot explain why buprenorphine was more common in regional areas. The design was cross-sectional, so it can describe reported differences but cannot show that transport, medication type or substance use caused differences in treatment access.
Declared interests
Paul Haber and Nicholas Lintzeris received research funding from Indivior and Camurus for opioid-related research. All other authors declared no conflicts. The study was funded by the New South Wales Ministry of Health.
The easy way to misread this
Do not read lower past-month heroin use as evidence that regional clients use fewer substances or drive more safely. Alcohol, cannabis, stimulant, injecting drug and sedating medication use did not differ, and most driving offence measures did not differ by region.