Grant: DRA: PA - Priority Areas in Pandemic Prepareness and Health Emergencies Research

The opioid overdose crisis in Canada is a public health emergency that has claimed over 40,000 lives since 2016. Without prompt treatment, overdoses can cause cardiac arrest and brain injury, leading to admission to the intensive care unit (ICU). For patients with severe brain injury in the ICU, doctors have to make predictions about the neurological outcomes, quality of life, and expected disability to determine whether to continue or withdraw life-sustaining measures. While there are strict guidelines about which tests should be performed to help with these predictions, they do not specifically address drug use and overdose, the social and cultural situation of patients most vulnerable to overdose, or the attitudes of care providers that may interact with decision-making. Therefore, in this project, I aim to identify gaps in clinical guidelines for predicting outcomes after brain injury. First, I will examine how guidelines are followed in the ICU and whether there are differences in clinical practice for brain injury caused by opioid overdose compared to other causes such as irregular heartbeat. Second, I will study how ICU doctors and nurses make decisions, the challenges they face, and the improvement they need for current guidelines, and the perspectives, values, and priorities of patients and care partners. Third, I will produce a set of ethics recommendations, based on my findings, to be introduced to policymakers and integrated into updated guidance. Through this research, I will deliver a comprehensive understanding of current clinical practices and priorities for predicting outcomes after opioid overdose with evidence-based recommendations for future guidelines. Ultimately, I hope to improve the care and outcomes for patients affected by the ongoing opioid overdose crisis in Canada.