Grant: Operating Grant: Opioid Crisis Knowledge Synthesis

Problematic opioid use is an escalating public health challenge in Canada, dramatically increasing death, disability, and other harms. While considerable progress has been made in the development of evidence-based interventions, in the context of a toxic drug supply, social risk factors for overdose for opioid users frequently go unaddressed due to slow uptake of evidence in clinical practice and public health policy, resulting in upstream prevention efforts often failing to prevent harm from opioid use. Socioeconomic marginalization (SEM) -- including labour market exclusion, prohibited income generation (e.g. theft, drug dealing, street-based work), material insecurity (e.g. housing or food insecurity) and inadequate income -- is an important but under-explored area with respect to opioid use and associated overdose, and there are currently no systematic reviews that summarize the risk of SEM in producing or increasing overdose risk. This is a critical gap because knowing which elements of SEM are causing overdose will enable the most effective and efficient prevention and intervention tactics. Responding to an urgent need for a review of evidence on how SEM affects overdose the specific objectives of our proposed review are to: 1) conduct a systematic review of scientific evidence describing the relationship between SEM overdose and overdose risk among PWUD; 2) engage with Knowledge Users throughout the planning and execution of the review; 3) identify areas for potential intervention to reduce socioeconomic drivers of overdose risk; 4) undertake integrated knowledge translation activities to support widespread availability of review results and recommendations for action. This review has considerable potential to effectively summarize previously underutilized research evidence to drive policy change.