Changing Pattern of Opioid Users Attending an Opioid Agonist Treatment Clinic in North India.

Illicit opioid use is a major concern across the globe due to its adverse health consequences. Pharmacological intervention is regarded as the cornerstone of management of opioid dependence and the Opioid Agonist Treatment (OAT) is the most effective intervention for this chronic relapsing disorder. Since the pattern of use of illicit substances, like opioids, changes with the course of time, we studied the profile of patients registered in an OAT clinic of a tertiary care center in North India over last 8 years.  Retrospective chart review of patients registered in the OAT clinic was done. Comparisons were made among two periods (2012-2015 and 2016-2019).  Total number of opioid dependent patients registered in OAT clinic has increased from 139 in 2012 to 2015 to 309 in 2016 to 2019. Mean age at the first use of opioids has reduced significantly from 20.2 (± 2.7) years in 2012 to 2015 to 18.3 (± 3.2) years in 2016 to 2019 (  = 0.02). Parenteral route continues to remain as the dominant mode of use of opioids, though it has increased from 80.6 to 99% of users. There has been increased use of heroin over these years (12.2% in 2012-2015 to 72.5% in 2016-19) with concomitant decrease of pentazocine use (69.1-17.5%), respectively.  The changing demographic and opioid use pattern in the last couple of years among patients attending OAT clinic should alert the policy makers, so that an integrated approach is put into action for effective prevention and management of opioid use disorders.