Grant: CIHR Fellowship

Overdose death rates have increased dramatically in Canada in recent years, largely driven by contamination of the drug supply with illicitly manufactured synthetic opioids such as fentanyl. The overdose crisis has been hardest felt in British Columbia (BC), which declared a public health emergency in 2016. Strategies to address the overdose crisis have therefore become an urgent public health priority. Previous research and evidence have shown that gender plays a key role in shaping contexts of drug use (e.g., within sex work or intimate partnerships) and access to treatment and harm reduction services. Women access treatment with more severe substance-related profiles relative to men (e.g., physical/sexual violence and trauma), yet few services are women-specific. New Vancouver Coastal Health guidelines highlight grave gaps in supports and prevention for marginalized women, and several new models of care are being rolled out (e.g., women-only supervised consumption rooms). Clinical interventions to address the overdose crisis and expand access to evidence-based treatments in BC include randomized clinical trials (RCTs) on the efficacy of opioid agonist therapies (OAT), slow-release oral morphine (SROM), and psychedelic-assisted therapy. However, the gender-related impacts of these interventions remain poorly understood and under investigated. The proposed research will evaluate the impacts of 'naturally occurring' and clinical interventions (i.e., through prospective methods and RCTs) to address the overdose crisis using a gendered lens, to identify gender differences in treatment outcomes and barriers to accessing services. This project also aims to widely disseminate findings to support scale-up of gender-sensitive substance use programs and policies, and inform directions for future research. It is hoped that this research will make important contributions to optimizing gender-specific treatment and care for people who use drugs in Canada and internationally.