Grant: Operating Grant: Evaluation of Interventions to Address the Opioid Crisis

Supervised consumption services (SCS) are a key strategy to reduce overdoses and deaths associated with the opioid crisis in Canada. They provide clean, safe spaces where people who use drugs (PWUD) can consume opioids, or other substances, under medical supervision. Research demonstrates that SCS are effective in the community, but they have not been used or studied in acute care hospitals. This is problematic because PWUD have high rates of hospitalization, lengthy hospital stays, and Canadian data show that 44% continue drug use while admitted. Hospitals often do not adequately address the needs of PWUD, and can be risky places when patients feel they have no option but to use unsanctioned drugs alone or in unsafe areas, reuse and unsafely dispose of needles, and leave against medical advice. Edmonton's Royal Alexandra Hospital (RAH) has attempted to address these concerns by becoming the first acute care hospital in North America to offer SCS for inpatients. The SCS is designed to prevent overdose and other complications from ongoing substance use. It is a 24/7 service, staffed by nurses. Opioids account for 87% of the substances consumed at the SCS. The SCS is an innovative program that was developed ad hoc, because no academic research has reported on the provision of SCS in acute care. We plan to study the implementation of the SCS with the goals of providing evidence for its improvement and generating essential information to allow other hospitals to develop their own SCS programs. In conducting our evaluation we will: (1) collect and analyze data about RAH SCS patients, and (2) conduct one-on-one interviews with hospital patients and staff regarding their experiences with in-hospital SCS. Our findings will be used to develop guidelines for implementing and improving in-hospital SCS, leading to improved hospital care and outcomes for PWUD, and particularly patients with opioid use disorder.