Nafeh Frishta, Mbichila Tinkhani, Bouck Zachary, Scheim Ayden, Mitra Sanjana, Bonn Matthew, Morris Franky, Atkinson Kate, Mason Kate, Eeuwes Jolene, Strike Carol, Gomes Tara, Werb Dan, Karamouzian Mohammad
Centre On Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada.
Int J Ment Health Addict. 2025;23(3):2105-2115. doi: 10.1007/s11469-023-01219-3. Epub 2023 Dec 22.
Canada is experiencing an ongoing overdose crisis, driven by a toxic unregulated drug supply. Integrated safer supply pilot programs offer pharmaceutical alternatives, coupled with comprehensive support services, to individuals using unregulated drug supply who are at high risk of overdose. We collected data from December 2020 to January 2023 on clients receiving safer opioid supply from five frontline service providers in Toronto, Canada, using interviewer-administered questionnaires. We assessed the incidence rate ratio of self-reported overdose comparing pre- and post-enrolment in the programs and examined changes in the prevalence of social and substance use outcomes post-enrolment. Forty-one participants were recruited, of whom 26 were followed up for a median of eight months (interquartile range, 5.0-11.7). The incidence rate ratio of overdose comparing post-enrolment to pre-enrolment was 0.20 (95% confidence interval, 0.09-0.43). Participants reported several positive social and substance use outcomes at follow-up, including a reduction in reliance on the unregulated supply and reduced criminal activity. Future implementation of integrated safer opioid supply pilot programs with larger sample sizes and rigorous epidemiological designs could help further illustrate the potential impacts of these programs in reducing overdose rates in Canada.
The online version contains supplementary material available at 10.1007/s11469-023-01219-3.
加拿大正经历一场持续的药物过量危机,这是由有毒且不受监管的药物供应所驱动的。综合更安全供应试点项目为使用不受监管药物供应且药物过量风险高的个人提供药物替代品,并辅以全面的支持服务。我们使用访谈员管理的问卷,收集了2020年12月至2023年1月期间从加拿大多伦多的五个一线服务提供商处接受更安全阿片类药物供应的客户的数据。我们评估了项目入学前后自我报告的药物过量发病率比值,并研究了入学后社会和物质使用结果患病率的变化。招募了41名参与者,其中26人接受了随访,中位随访时间为8个月(四分位间距,5.0 - 11.7)。入学后与入学前相比的药物过量发病率比值为0.20(95%置信区间,0.09 - 0.43)。参与者在随访中报告了一些积极的社会和物质使用结果,包括对不受监管供应的依赖减少以及犯罪活动减少。未来实施样本量更大且有严格流行病学设计的综合更安全阿片类药物供应试点项目,可能有助于进一步说明这些项目在降低加拿大药物过量率方面的潜在影响。
在线版本包含可在10.1007/s11469 - 023 - 01219 - 3获取的补充材料。