Grant: Operating Grant

The harms associated with problematic illicit drug use are among the largest threats to individual, community and public health in Canada. While there are a number of effective interventions to mitigate drug-related harm, including drug-based addiction treatment, there remain significant gaps in our ability to address the alarming human, social and economic costs of illicit drugs. Several randomized controlled trials (RCTs) are therefore being initiated in Vancouver to examine the efficacy of novel addiction treatment and harm mitigation strategies. However, past RCTs among marginalized populations have identified issues of significant consequence to experiences of trial participation and the effective and ethical execution of RCTs. These issues have significantly impacted the success of trial-based research, but have focused on individual- and trial-level attributes that have not been fully explored in the unique context of addiction RCTs. This grant therefore proposes a program of research companion to addiction RCTs in Vancouver that examines the individual, and social, structural dimensions of addiction RCT participation among people who use drugs. It seeks to (1) examine the individual, social and structural determinants of motivations, barriers and willingness to participate in addiction RCTs; (2) assess the individual, social and structural correlates of RCT trial preparedness; (3) explore attitudes about and experiences of addiction RCT participation, before, during, and following trial completion; and (4) identify individual, social and structural determinants of protocol adherence and trial participation completion. By partnering with addiction RCTs this research will focus on actual rather than hypothetical research scenarios and evaluate participation dimensions longitudinally from pre-trial preparedness through to post-trial reflection.