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

Supervised injection services are an important part the public health and clinical response to Canada's opioid crisis. Past evaluations have demonstrated multiple benefits associated with supervised injection sites. However, some of the benefits may be specific to the context in which supervised injection services are delivered. In Ontario, supervised injection has been offered in 9 medium-sized supervised injection facilities, which have long-term exemptions from federal drug laws to allow them to operate. These facilities have comprehensively integrated health and social services. Ontario has also implemented 8 overdose prevention sites, which are sites in community agencies with short-term exemptions; they may not have all of the features in supervised injection sites but can be established rapidly and at low cost. Recently, the Ontario government has indicated they intend to review the evidence for supervised injection services. There is therefore a pressing need to evaluate supervised injection services in Ontario. We will examine the effects of implementing a supervised injection or overdose prevention service on overdoses in the neighbourhoods in which such services open. We will use methods that take into account changing effects over time (such as drug composition) and effects that supervised injection may have on overdoses in adjoining neighbourhoods. We will evaluate opioid-related deaths, emergency department visits for opioid-related overdose, hospital admissions, and ambulance calls. We will also assess whether supervised injection sites and overdose prevention sites had similar effects. These studies build upon our prior work and our strong partnerships with community members and public health officials. Our study will establish an evidence base for assessing the effects of supervised injection services in Ontario and can meaningfully inform policy discussions regarding the optimal suite of harm reduction interventions to address the opioid crisis.