Grant: CIHR Fellowship

Canada is currently addressing two major and converging public health crises: the opioid overdose crisis and the COVID-19 pandemic. There is emerging evidence that the intersection of these two crises is exacerbating the loss of life from overdose, likely due to the combination of physical distancing measures and service restrictions/closures to reduce the spread of COVID-19. Safer Supply programs have been proposed as a novel strategy to address overdose deaths, by providing people using street-acquired opioids with a prescription for pharmaceutical opioids of known dose and potency. While Safer Supply programs were being implemented in Ontario prior to the COVID-19 pandemic, in BC this approach was operationalized following the publication of the Risk Mitigation in the Context of Dual Public Health Emergencies guidelines early in the response to the COVID-19 pandemic. This research project will use comparative case study methods and longitudinal qualitative interviews with Safer Supply program clients and staff in both provinces to explore and compare the operationalization in Ontario and BC of Safer Supply programs. It will explore differences in implementation and impacts of these programs on clients' ability to reduce overdose risk, facilitate COVID-19 physical distancing, and access broader health and social services. Given the newness and novelty of Safer Supply programs, and their recent deployment to both reduce overdose incidence and facilitate isolation during COVID-19 for people who use drugs, this research will contribute to the develop of the evidence base on the impacts and efficacy of Safer Supply programs in the two provinces hardest hit by the overdose crisis. This research is well-positioned to provide key information for policy makers and service planners for use in health systems decision-making and possible scale-up in provinces and territories across Canada.