Grant: Project Grant

The drug toxicity overdose crisis in Canada led to the scale-up of harm reduction services, including supervised consumption sites (SCS) and prescribed safer supply programs. SCS provide a monitored setting to use pre-obtained drugs with overdose intervention if needed, while safer supply programs offer pharmaceutical alternatives to the unregulated drug supply composed primarily of highly potent fentanyl. Both interventions have been shown to reduce overdose deaths. In 2024, the Ontario Government announced it will close 10 SCS by March 2025 and replace them with Homelessness and Addiction Recovery Treatment (HART) hubs, focussing on abstinence-based treatment and prohibiting harm reduction services, including SCS, safer supply programs, and sterile injection equipment distribution. Our study will evaluate the impacts of service closures using longitudinal qualitative interviews, ecological analysis of neighborhood-level data, simulation modeling, and health administrative data. We will assess changes in health outcomes, including overdoses, HIV and hepatitis C infections, and access to healthcare and harm reduction services. Our project will use multiple methods to generate high-quality evidence on the impact of harm reduction service delivery changes, and provide actionable research on the impact of these closures on efforts to address the toxic drug crisis and improve outcomes for people who use drugs.