Grant: CIHR Fellowship

Opioid overdose has caused more deaths in Canada than seen at the peak of the HIV epidemic in the 1990s. Overdose prevention sites (OPS) and injectable opioid agonist treatment (iOAT) are two new approaches to this issue. Community-based OPS monitor people at risk of overdose and provide rapid overdose response. They also offer access to education, addiction treatment and social services. iOAT is an addiction treatment for people who have not had success on oral medications. Both of these services save lives and reduce harm to people with severe opioid use disorders. Implementation of these services has begun, primarily in British Columbia. Yet, implementing evidence-based interventions broadly in health care usually takes 10-20 years. Greater urgency is needed. Implementation science (IS) is a research field focused on finding the best ways to shorten this gap. No IS research currently exists to guide the implementation and spread of these services in Canada's healthcare system. National planning requires evidence about which implementation strategies are effective in different settings. This study is the first of its kind in North America. We will engage policy makers, health care providers, people who use drugs and the recovery community. Together, we will identify factors supporting or hindering implementation in British Columbia and Canada. We will then test the effectiveness of different implementation strategies in different settings. Some of these strategies will include education, changing policy and improving communication networks. Effective implementation will mean better access to these life-saving interventions. Access will help keep more people in addiction treatment and decrease the risk of overdose and other health issues. These benefits will reduce burden on families and on the Canadian health and justice systems.