Mirza Nyal, Mathias Holly, Hyshka Elaine
School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Can J Public Health. 2025 May 13. doi: 10.17269/s41997-025-01057-x.
Supervised consumption services (SCS) and overdose prevention services (OPS) are core interventions for reducing risks of overdose death, HIV, and hepatitis C (HCV) and supporting the health of people who use drugs. However, most SCS/OPS are concentrated in major urban centres. There is an urgent need for the expansion of SCS/OPS in rural and small population centres across Canada, particularly given rising rates of drug-related mortality and morbidity in these settings. This commentary outlines current knowledge of SCS based in rural and small population centres, including availability and key barriers and facilitators of implementation and access. To support a public health approach that reduces drug-related mortality and morbidity, further research is needed on scaling up SCS/OPS in communities of all sizes. Alternative delivery models, including virtual and mobile, and the role of informal peer networks have the potential to enhance SCS/OPS in rural and other low resource settings.
监督下使用服务（SCS）和过量用药预防服务（OPS）是降低过量用药死亡、艾滋病毒和丙型肝炎（HCV）风险以及支持吸毒者健康的核心干预措施。然而，大多数SCS/OPS集中在主要城市中心。加拿大农村和人口较少的中心迫切需要扩大SCS/OPS，特别是考虑到这些地区与毒品相关的死亡率和发病率不断上升。本评论概述了农村和人口较少中心基于SCS的现有知识，包括可用性以及实施和获取方面的主要障碍和促进因素。为了支持降低与毒品相关的死亡率和发病率的公共卫生方法，需要进一步研究在各种规模的社区扩大SCS/OPS。包括虚拟和移动服务在内的替代提供模式以及非正式同伴网络的作用，有可能加强农村和其他资源匮乏地区的SCS/OPS。
