Opioid agonist treatment (OAT), using medications like methadone or buprenorphine, is the gold standard for treating opioid use disorder, but many patients also live with significant chronic pain. This research was part of the POINT study and examined how prescriptions for opioid painkillers change when people start OAT, and which patients are most likely to continue receiving these medications.
Using health registries, this study followed nearly 3800 people starting OAT and examined opioid prescribing before and after treatment began. Over a third of the “treatment naïve” patients had been prescribed opioid painkillers (like codeine, tramadol or stronger opioids) in the year before starting OAT. One year after starting OAT, that share had dropped to about one in five, and the average daily dose of opioids fell across the board.
However, the study also showed that not everyone followed the same pattern. Women, people over 56, and those with recorded pain diagnoses or mental health conditions such as depression, anxiety, bipolar disorder or schizophrenia were more likely to continue receiving opioid painkillers after starting OAT. This suggests that for many patients with complex needs, OAT may reduce overall opioid exposure but does not fully solve the challenge of managing chronic pain or psychiatric comorbidity. The findings support the need for careful, integrated care: effective OAT combined with proactive pain management and mental health support.