Ivsins Andrew, Sutherland Christy, Kerr Thomas, Kennedy Mary Clare
British Columbia Centre on Substance Use, Vancouver, BC, Canada.
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Am J Drug Alcohol Abuse. 2025 May 6:1-10. doi: 10.1080/00952990.2025.2497800.
North America is experiencing an unrelenting overdose crisis driven by a volatile and toxic unregulated drug supply. Safer supply programs, which provide individuals with pharmaceutical-grade alternatives to the unregulated drug supply, have been implemented in various Canadian jurisdictions. While most programs provide tablet hydromorphone, the Safer Alternatives for Emergency Response (SAFER) program in Vancouver, Canada, offers pharmaceutical-grade fentanyl, including a powder formulation for witnessed consumption. To explore early experiences among SAFER program participants receiving powder fentanyl. Qualitative one-on-one interviews were conducted with 18 (12 men, 6 women) people prescribed fentanyl powder from the SAFER program. Interview coding and analysis involved a team-based approach to identify common themes related to program experiences, focusing on impacts on unregulated drug use. Most (13/18; 72%) participants reported reducing unregulated drug use since program enrollment. This was largely attributed to the SAFER fentanyl powder being effective for managing withdrawal, thereby limiting their need to access street-purchased drugs. Additionally, some participants, particularly those prescribed higher doses, suggested that SAFER fentanyl powder, unlike other safe supply medications, was a suitable alternative to street-purchased fentanyl. Participants also reported reduced overdose risk. Operating hours and dosing challenges were barriers to program engagement contributing to continued unregulated drug use for some. Our findings demonstrate a number of positive outcomes of the SAFER program and suggest that fentanyl safer supply has the potential to play a useful role in addressing the ongoing overdose crisis.
北美正经历一场由不稳定且有毒的非法药物供应引发的持续不断的过量用药危机。在加拿大的各个司法管辖区已实施了更安全供应项目，该项目为个人提供合法药物来替代非法药物供应。虽然大多数项目提供片剂氢吗啡酮，但加拿大温哥华的应急更安全替代方案（SAFER）项目提供合法的芬太尼，包括一种用于现场服用的粉末制剂。为了探究接受芬太尼粉末的SAFER项目参与者的早期经历。对18名（12名男性，6名女性）从SAFER项目中获得芬太尼粉末处方的人员进行了定性一对一访谈。访谈编码和分析采用基于团队的方法，以确定与项目经历相关的共同主题，重点关注对非法药物使用的影响。大多数（13/18；72%）参与者报告称自加入项目以来减少了非法药物的使用。这在很大程度上归因于SAFER芬太尼粉末对控制戒断有效，从而减少了他们购买街头毒品的需求。此外，一些参与者，特别是那些被开了高剂量处方的人表示，与其他合法供应药物不同，SAFER芬太尼粉末是街头购买芬太尼的合适替代品。参与者还报告称过量用药风险降低。运营时间和剂量方面的挑战是参与项目的障碍，导致一些人继续使用非法药物。我们的研究结果证明了SAFER项目的一些积极成果，并表明芬太尼更安全供应有可能在应对持续的过量用药危机中发挥有益作用。
