Grant: Health System Impact Fellowships - PostDoc Western Canada 2-year

British Columbia (BC) declared a public health emergency in 2016 due to an alarming rise in opioid-related overdoses and deaths. In response, BC has seen major shifts in opioid use disorder (OUD) care. For example, there have been changes in how medications for OUD (MOUD) are prescribed, expanded MOUD coverage, and the introduction of new harm reduction programs and policies. However, there remains little real-world evidence on how these changes have affected OUD outcomes. Vancouver Coastal Health (VCH) is one of five regional health authorities in BC, serving one of the epicentres of Canada's overdose crisis -the Vancouver Downtown Eastside. It has been a leader in providing care for nearly 20,000 people with OUD in the province, while keeping up with changes in treatment approaches and health system policies. In this project, I will partner with VCH to work directly with clinical and policy leaders to generate evidence on the impact of these system-level reforms using real-world administrative and clinical data. We will look at treatment retention, overdose and mortality risk, as well as healthcare use and explore factors affecting these outcomes. I will use innovative study designs and methods to improve the quality of evidence and make it more useful for real-world decisions. Findings from this study have the potential to inform more targeted interventions that are both effective and safe, expand OUD treatment options, and inform policy and guideline development within VCH region, across BC and beyond. We will share findings with doctors, policy makers, and the community through clear, accessible presentations and reports. Ultimately, this project aims to turn complex big data into actionable evidence-based knowledge that enhances patient outcomes, reduces harm, and optimizes the efficiency of the healthcare system in tackling the opioid crisis.