Grant: Project Grant

Rates and impacts of opioid misuse among Indigenous communities are difficult to quantify, a task complicated by the challenge of not perpetuating a deficit lens (i.e., victim-blaming, moralization) when identifying drivers of negative opioid-related outcomes among under-served and racialized populations. This study seeks to contextualize structural drivers (i.e., factors embedded in wider social, political and health systems) that shape opioid-related health disparities among First Nations (FN) in Alberta. Together with 4-5 FN partners connected to the research team through the Alberta First Nations Information Governance Centre, the mixed methods study will mobilize administrative data around access to prescription opioids among non-cancer FN patients, linking these to patient, family, community & provider experiences collected in sequential focus groups and interviews. Once quantitative and qualitative data are integrated, FN stakeholders will engage in a consensus-building process to prioritize key areas and opportunities for enhancing provider capacity for responsible prescribing. Data sources include prescription insurance claims made by dispensers to the Non-Insured Health Benefits program, medical college prescription surveillance data from Alberta's Triplicate Prescription Program (TPP), and potentially Alberta Health practice data. Analysis for structural drivers will focus, for instance, on physician parameters (e.g., prof. & educ. background, patient panel sizes), as well as system, social, and political resources supporting or impeding chronic disease and pain management. The study positions the team for future partnership with Primary Care Networks to identify the influence of patient panels (e.g.,size, composition, geographic range) & health utilization data (e.g.,duration of visits, access to allied health professionals for pain). Evidence developed will orient FN & research partners to develop and evaluate interventions for responsible prescribing.