Grant: Project Grant

Canada is experiencing a prolonged overdose crisis driven by a volatile and toxic illicit drug supply. Among the responses to this crisis are programs that offer pharmaceutical alternatives to the toxic drug supply-or prescribed safer supply (PSS). Canadian researchers have generated evidence documenting the benefits and challenges of PSS and revealing critical gaps in consistency, implementation, and sustainability across the country. To date, there has been no coordinated national effort to capture these variations in policy and programs. As a result, key questions remain unanswered about how differences in provincial and territorial policies influence PSS practices, health service engagement, and overdose risk. There is a critical need to answer these questions, as recent policy shifts around PSS and harm reduction more broadly are poised to affect how people at risk of overdose engage (or not) with health services, with potentially profound consequences for health outcomes. The lack of a national synthesis limits the ability of policy makers and health systems to learn from the past, identify transferable lessons, and design coherent and equitable responses to the toxic drug crisis. This 4-year study involves a national synthesis and evaluation of PSS policy and practice, designed to systematically map policies, examine how program changes over time have shaped health outcomes, and synthesize findings to identify lessons and recommendations to support future responses to the toxic drug crisis. Across objectives, we will consider the unique contexts and policy implications of smaller cities, rural and remote settings, and key population subgroups (women, gender diverse people, Indigenous and racialized identities, and people who are unhoused). This research is essential as we think forward to the next generation of overdose prevention strategies in Canada and internationally.