Impact of overdose prevention sites during a public health emergency in Victoria, Canada

Abstract

The primary objective of this study was to examine the impacts associated with implementation of overdose preventions sites (OPSs) in Victoria, Canada during a declared provincial public health overdose emergency. A rapid case study design was employed with three OPSs constituting the cases. Data were collected through semi-structured interviews with 15 staff, including experiential staff, and 12 service users. Theoretically, we were informed by the Consolidated Framework for Implementation Research. This framework, combined with a case study design, is well suited for generating insight into the impacts of an intervention. Zero deaths were identified as a key impact and indicator of success. The implementation of OPSs increased opportunities for early intervention in the event of an overdose, reducing trauma for staff and service users, and facilitated organizational transitions from provision of safer supplies to safer spaces. Providing a safer space meant drug use no longer needed to be concealed, with the effect of mitigating drug related stigma and facilitating a shift from shame and blame to increasing trust and development of relationships with increased opportunities to provide connections to other services. These impacts were achieved with few new resources highlighting the commitment of agencies and harm reduction workers, particularly those with lived experience, in achieving beneficial impacts. Although mitigating harms of overdose, OPSs do not address the root problem of an unsafe drug supply. OPSs are important life-saving interventions, but more is needed to address the current contamination of the illicit drug supply including provision of a safer supply.

“Running myself ragged”: stressors faced by peer workers in overdose response settings

“…In this context, peer workers are those with past or present drug use experience who use that lived/living experience to inform their professional work [10]. Peer workers inform and lead nimble and effective overdose response and prevention services for people who use drugs (PWUD) [11][12][13][14] within overdose response settings. 1 These include stand-alone supervised consumption sites and overdose prevention services (OPSs), as well as services in shelter and housing agencies.…”

“…A growing body of evidence indicates that peer worker-led programs are successful in creating “safe spaces” for PWUD [ 12 , 14 , 18 – 21 ] and help to reduce harmful health behaviours such as sharing substance use supplies and unsafe sex practices [ 22 , 23 ]. Peer-led programs also improve program accessibility and acceptability [ 10 ], help in building connections and trust [ 24 ], facilitate environments of comfort and safety for service users [ 12 , 13 ], and are associated with mental health benefits for PWUD [ 25 ].…”

To what extent do supervised drug consumption services incorporate non-injection routes of administration? A systematic scoping review documenting existing facilities

“…People engaged in public non-injection drug consumption report experiencing violence when using in public areas, from police and others [ 15 , 16 ]. SCS that incorporate non-injection routes of consumption have the potential to reduce the risk of these harms through provision of emergency medical care, a safe environment, and sterile smoking and intranasal consumption supplies [ 17 – 20 ]. Additionally, providing access to SCS that incorporate non-injection routes of consumption may reduce the risk of transitioning to injection [ 21 ].…”

“An Emotional Roller-Coaster:" Stressors Faced by Peer Workers in Overdose Response Settings

“…In this context, experiential workers are those with past or present drug use experience who use that lived experience to inform their professional work [10]. Experiential workers inform and lead nimble and effective overdose response and prevention services for PWUD [11][12][13][14] within overdose response settings. These include stand alone supervised consumption sites and overdose prevention services (OPSs), as well as services in shelter and housing agencies.…”