Theme: Epidemiology & Public Health Research Year: 2025
Background:
Canada is amid a worsening overdose crisis, driven largely by the unregulated drug supply. Safer opioid supply (SOS) programs were implemented to provide pharmaceutical-grade opioids alongside wraparound health and social services. In August 2024 Ontario’s provincial government introduced restrictions on harm reduction initiatives, coinciding with the expiration of federal funding, forcing many SOS programs to close.
Methods:
We conducted 25 semi-structured qualitative interviews with people who use drugs enrolled in six SOS programs across Ontario. We conducted a thematic content analysis. Interviews were conducted virtually and explored participants’ experiences with SOS programs, anticipated impacts of program closures, and potential strategies to mitigate risks with the closure of the SOS programs.
Results:
Over two-thirds (68%) of participants indicated that their drug of choice was street opioids such as fentanyl. Majority (72%) of participants indicated that smoking was their preferred mode of consumption. We identified two overarching themes the first being The Role and Impact of SOS Programs: Current Benefits and Future Consequences with sub themes such as drug use patterns, overdose risk, and quality of life. The second overarching theme was Coping with Uncertainty and Adapting to Change in light of SOS Program Closures with sub themes such as consideration of OAT, Self VS Staff-Imposed Tapering, and Seeking Alternative Clinics or Prescribers.
Conclusion:
This study highlights participants’ concerns that SOS program closures may force them back into an increasingly dangerous unregulated market, ultimately putting their lives at risk. In addition to reversing the many benefits SOS programs provided, such as connections to essential health and social services. By replacing harm reduction programs with treatment services, the government is not reducing the demand for opioid use, instead, it forces people to return to the unregulated drug market, ultimately putting individuals at risk of overdose.
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