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Article History

Accepted: 8 June 2025

First Online: 3 July 2025

Declarations

:

: This work was supported by the Canadian Institutes of Health Research (CIHR), Project Grant programme, grant number 436351 (principal investigator: DP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. RWP is the Albert Boehringer Chair in Pharmacoepidemiology at McGill University. DP holds a Canada Research Chair Tier 2 in the Economics of Harm Reduction.

: The authors declare that they have no competing interests.

: Not applicable.

: Consent was obtained from all co-authors, and no other consent to publish was required.

: Available upon request.

: JL conceived the study, conducted statistical analysis, and drafted and revised the paper. JB provided clinical expertise and helped validate and interpret study results. RWP provided methodological and statistical expertise to help validate and interpret study results. DP acquired the funds to enable this study, acquired the data, reviewed and revised the draft paper, and supervised this project. All authors read and approved the final manuscript.

: The McGill University Research Ethics Board (A08-E53-19B; first approval date: 2019/08/26) and Quebec Access to Information Commission (1026586-S; 2021/09/20) approved the protocol. We rounded all frequencies to the nearest multiple of 5 or 10, as required by the Institut de la Statistique du Québec. Due to the retrospective nature of this study, informed consent was waived.

: The administrative data that support the findings of this study are available only through the CADRISQ site, a secure research environment accessible only to accredited researchers in Quebec for research purposes. Access to the de-identified, individual records are restricted on both legal and ethical grounds, given the sensitive nature of individual’s health data (e.g., medical and pharmacy claims records). The data are owned by third-party organizations affiliated with the Government of Québec, including Régie de l'assurance maladie du Québec (RAMQ) and Ministère de la santé et des services sociaux (MSSS). Request for access can be made via Zone recherche (). For additional information regarding the access to research data, please contact: sad@stat.gouv.qc.ca. Data requests must be made with permission from the Institut de la Statistique du Québec. For more information, please visit: .