Systematic review on intentional non-medical fentanyl use among people who use drugs
Research
Azar Lab is at the forefront of addiction medicine research, leveraging pharmacology, digital health, and clinical innovation to tackle the complexities of the fentanyl era.
We harness artificial intelligence to push the boundaries of safety and care. Our work includes molecular labeling innovations that help intercept illicit opioids while protecting legitimate medical use, as well as AI-powered recovery platforms that integrate data and behavioral insights to personalize long-term treatment and support.
We have developed innovative rapid induction protocols for buprenorphine, specifically tailored for individuals who use fentanyl, recognizing the unique challenges posed by high-potency synthetic opioids. In parallel, our Rapid Opioid Agonist Therapy (rOAT) approach enables fast-tracking of methadone or sustained-release oral morphine to therapeutic doses from day one, ensuring timely symptom relief and improving engagement in care.
We are pioneering approaches that use carefully dosed full-agonist opioids, including fentanyl, to manage withdrawal safely and effectively. This work challenges outdated paradigms and opens doors to more humane, patient-centered care.
Our team applies advanced pharmacokinetic modeling and bench-to-bedside research to personalize treatment protocols. By understanding how opioids and medications interact in real-world settings, we can optimize safety and therapeutic impact.
We are building interactive simulation tools that allow clinicians to practice complex addiction medicine scenarios in a risk-free environment. These “virtual patients” accelerate training and help standardize best practices across diverse care settings.
From portable opioid detectors to millimeter-wave Doppler monitoring systems, we are creating technologies that enhance safety in both clinical and community settings. These tools expand the possibilities for real-time detection, monitoring, and intervention.
All research
Medical Devices
Development of a Graphene-Oxide-Deposited Carbon Electrode for the Rapid and Low-Level Detection of Fentanyl and Derivatives
Daniel Jun, Glenn Sammis, Pouya Azar, Erwann Ginoux, Dan Bizzotto
This study describes a graphene-enhanced electrochemical sensor for ultra-sensitive detection of fentanyl and analogues in drug samples or fluids.
Public Health
Systematic review on intentional non-medical fentanyl use among people who use drugs
Vivian W. L. Tsang, James S.H. Wong, Jean N. Westenberg, Noor H. Ramadhan, Hasti Fadakar, Mohammadali Nikoo, Victor W. Li, Nick Mathew, Pouya Azar, Kerry L. Jang, Reinhard M. Krausz
This review investigates the prevalence, motivations, and associated risks of intentional non-medical fentanyl use among people who use drugs.
Public Health
A Call for an Evidence-Based Strategy Against the Overdose Crisis
R. Michael Krausz, Pouya Azar, et al.
This perspective article argues for an evidence-based approach to tackle North America's overdose crisis, challenging the uncritical adoption of 'safe supply' policies.
Primary Prevention
Towards an International Consensus on the Prevention, Treatment and Management of High-Risk Substance Use and Overdose among Youth
Pouya Azar, et al.
An international position paper proposing a comprehensive framework for addressing high-risk substance use and overdose among youth.
Applied Pharmacokinetics
Case report: acute care management of severe opioid withdrawal with IV fentanyl
Pouya Azar, Jean N. Westenberg, Martha J. Ignaszewski, et al.
Presents a case of using IV fentanyl to manage withdrawal and pain in a hospitalized fentanyl-dependent patient.
Clinical Protocol Development
Short communication: Systematic review on effectiveness of micro-induction approaches to buprenorphine initiation
Jessica Moe, Pouya Azar, et al.
This systematic review synthesizes evidence on buprenorphine micro-induction for opioid use disorder, a method designed to reduce withdrawal.
Applied Pharmacokinetics
Comparing rapid micro-induction and standard induction of buprenorphine/naloxone for treatment of opioid use disorder: protocol for an open-label, parallel-group, superiority, randomized controlled trial
James S. H. Wong, Mohammadali Nikoo, Jean N. Westenberg, et al.
Outlines a trial comparing standard vs. rapid micro-induction methods for initiating buprenorphine/naloxone in opioid use disorder patients.
Clinical Protocol Development
Microdosing and standard-dosing take-home buprenorphine from the emergency department: A feasibility study
Jessica Moe, Pouya Azar, et al.
This study evaluates the feasibility and patient acceptability of microdosing vs. standard dosing buprenorphine from the emergency department.
Applied Pharmacokinetics
Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach
Jennifer Rozylo, Keren Mitchell, Mohammadali Nikoo, et al.
Microdosing induction using the Bernese Method in a high-risk patient via assertive outreach, avoiding withdrawal symptoms.
Applied Pharmacokinetics
Rapid Induction of Buprenorphine/Naloxone for Chronic Pain Using a Microdosing Regimen: A Case Report
Danny S. Lee, Jessica E. Hann, Sukhpreet S. Klaire, Mohammadali Nikoo, Michael D. Negraeff, Pouya Rezazadeh-Azar
Describes a case using rapid microdosing to transition a patient from methadone/oxycodone to buprenorphine without withdrawal.
Applied Pharmacokinetics
A Review of Novel Methods To Support The Transition From Methadone and Other Full Agonist Opioids To Buprenorphine/Naloxone Sublingual In Both Community and Acute Care Settings
Sumantra Monty Ghosh, Sukhpreet Klaire, Robert Tanguay, Mandy Manek, Pouya Azar.
This review presents novel methods for transitioning individuals from methadone and other full opioid agonists to buprenorphine/naloxone SL. These include community and acute care protocols aimed at minimizing withdrawal and improving induction outcomes. Protocols discussed include methadone tapering, microdosing, bridging techniques, and patch-based approaches. The article emphasizes clinical acumen and individualized treatment plans due to limited comparative trial data.
Applied Pharmacokinetics
Buprenorphine/naloxone induction for treatment of acute on chronic pain using a micro-dosing regimen: A case report
Raman Sandhu, Rebecca Zivanovic, Sukhpreet Klaire, Mohammadali Nikoo, Jennifer Rozylo, Pouya Azar
Postoperative patient with chronic pain and OUD transitioned to buprenorphine/naloxone using micro-dosing without opioid withdrawal.
Public Health
Understanding the mental health and recovery needs of Canadian youth with mental health disorders
SPOR Collaboration including Pouya Azar
A collaborative protocol for developing patient-oriented research to address the mental health and recovery needs of Canadian youth.
Applied Pharmacokinetics
Methadone to Buprenorphine/Naloxone Induction without Withdrawal Utilizing Transdermal Fentanyl Bridge in an Inpatient Setting—Azar Method
Pouya Azar, Mohammadali Nikoo, Isabelle Miles
Case report of a patient transitioned from methadone to buprenorphine without withdrawal using a fentanyl patch as a pharmacologic bridge.
Public Health
Drug use patterns associated with risk of non-adherence to antiretroviral therapy among HIV-positive illicit drug users in a Canadian setting
Pouya Azar, et al.
This longitudinal study analyzes how various patterns of drug use influence adherence to antiretroviral therapy (ART) in HIV-positive individuals.