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mixed-methods evaluation of the impact of decriminalization on harm reduction and opioid agonist treatment (OAT) services


PI: Dr. JΓΌrgen Rehm, Institute of Mental Health Policy Research, CAMH, ON and Ontario CRISM Node Team (OCRINT)

Co-PI: Dr. Farihah Ali, Institute of Mental Health Policy Research, CAMH, ON and Ontario CRISM Node Team (OCRINT)

Project Lead: Ms. Cayley Russell, Institute of Mental Health Policy Research, CAMH, ON and Ontario CRISM Node Team (OCRINT)

Working Group:  Dr. Alexis Crabtree (BC Centre for Disease Control);  Dr. Rita Shahin (Toronto Public Health); Ms. Sierra Williams (BC Centre for Disease Control); Mr. Frank Crichlow (Canadian Association of People who use Drugs); Mr. Sean Patenaude (Centre for Addiction and Mental Health); Dr. Laura McKinnon (Vancouver Coastal Health; First Nations Health Authority); Ms. Kate Hodgson (BC Centers for Substance Use; First Nations Health Authority); Ms. Jessica Xavier (BC Centre for Disease Control)


We will administer an annual longitudinal online survey of representatives who provide harm reduction and treatment services directly to adult PWUD in BC to routinely capture and collect province-wide data pertaining to the operationalization of these services in terms of waitlists, admissions, uptake, engagement, and retention in treatment, etc. It will be important to monitor the impacts of decriminalization on these services and the clients they serve going forward.

We plan to connect with appropriate and relevant organizations that offer harm reduction and treatment services for adults in BC, by collaborating with relevant networks and CRISM contacts. These networks will help us identify and connect with a sample of harm reduction and treatment services that are representative of the five Health Authorities (i.e., Interior, Fraser, Vancouver Coastal, Vancouver Island, and Northern), and their respective Health Service Delivery Areas (HSDAs), and local health areas.

Harm reduction services will include supervised consumption sites, overdose prevention services, needle exchange programs, safe supply programs and drug checking programs as these are low-barrier services which are integrated into many PWUD communities and will likely see a strong demand under decriminalization. Harm reduction service questions will focus on the following:

  • Service capacity
  • Services offered
  • Service utilization/uptake
  • Resources (personnel, infrastructure, and funding)
  • Referral pathways
  • Clientele specifics (demographics, substance use profiles, etc.)

T
reatment services will include opioid agonist treatment (OAT) providers and clinics. OAT is the recommended first-line treatment for opioid use disorder and PWUD who may become interested in seeking treatment post-decriminalization may likely be prescribed OAT. It is therefore likely that we will see an increase in demand and engagement with OAT. OAT service questions will focus on the following:

  • Service capacity
  • Provider information (e.g., physician, nurse practitioner, pharmacist)
  • Waitlists
  • Eligibility criteria
  • Types of OAT offered
  • Access to and provision of OAT take-home doses
  • Service utilization/uptake
  • Treatment retention
  • Resources (personnel, infrastructure, and funding)
  • Referral pathways
  • Clientele specifics (demographics, substance use profiles, etc.)