Grant: Project Grant

The toxic drug supply and overdose crises continue to claim lives in Canada at unprecedented rates. Getting more people access to life saving treatments in more ways is urgently needed. For people with opioid use disorder (OUD), several medications can support their opioid needs. One form of medication assisted treatment is injectable opioid agonist treatment (iOAT), wherein clients are prescribed injectable opioids (e.g., pharmaceutical grade heroin) in safe, individualized doses. iOAT has proven to reach and treat clients who the system is otherwise unable to engage in care. Indeed, in 2020, the Canadian Minister of Health wrote to all provincial Ministers of Health and health profession regulators asking them to do all they can to support "programs that provide greater access to a safer, pharmaceutical-grade alternative to the toxic street supply". Despite this, iOAT has only expanded to a limited degree in Canada for reasons such as tight provision restrictions that make participation difficult. For example, medications are not allowed to leave the site. Providers expressed these restrictions do not align with a person-centered care approach and perpetuate stigma. Given that iOAT currently has accessibility barriers that do not align with the principles of disability justice (e.g., clients have to come to the clinic multiple times every day), this project will expand our research to support accessible and equitable iOAT. Using both quantitative and qualitative methodologies, we will interview most of the clients receiving iOAT in BC on how disability and accessibility intersect with iOAT, including how they see iOAT evolving to meet their ever-changing accessibility needs. As providers have previously shared that the current system-level iOAT guidelines prevent them from providing person-centered care, we will also interview providers across Canada on tangible, specific steps they believe should be taken to improve treatment delivery, accessibility, and equity.