Grant: Op Gr: Eval of Harm Reduct. Appro. Address the Opioid Crisis - SCS Eval. Ontario

The opioid overdose crisis and the COVID-19 pandemic are 2 major public health problems in Canada. People who use drugs are at high risk for harms during the pandemic due to changes in the drug supply, uncertain economic instability, and increased isolation. Supervised injection services may help to address these risks. Currently, there are 19 supervised injection sites in Ontario. Fewer than 1 in 10 opioid-related overdose deaths in Ontario occurred in a region in which there was a supervised injection site. Our study will examine the best models for supervised injection sites, how these sites can be sustained over time, and how to address barriers to using sites for specific groups, including people who are racialized and Indigenous, women, and people who use stimulants. We will use a mathematical model to examine how to maximize flow through supervised injection sites. We will also address the public health effects of supervised injection sites during the COVID-19 pandemic and both the experienced and potential impact of scaling up or scaling down supervised injection services in Ontario. Our study will have direct relevance for public health and health policy and will help all stakeholders address which SCS models are the best, for which people, in which contexts, and at which times, including during the COVID-19 pandemic.