Theme: Epidemiology & Public Health Research Year: 2024
Background: Supervised consumption services (SCS) (also known as overdose prevention sites/centres or drug consumption rooms) are an important intervention for reducing risks of overdose death, HIV, hepatitis C (HCV) and supporting the health of people who use drugs. However, most research on these services is concentrated in major urban centres. Far less is known about SCS designed to support populations in rural, remote, or lower resource settings. To address this knowledge gap, we conducted an environmental scan outlining SCS delivery in rural/small population centres across Canada (which has 38 federally authorized SCS and over 45 OPS in operation).
Methods: An environmental scan approach was conducted. We systematically searched academic databases (e.g. PubMed, SCOPUS) and Google for English-language peer-reviewed and grey literature on SCS in rural settings published before June 2024. Key concepts and ideas were synthesized to provide a narrative summary of delivery models, barriers/facilitators of access, community perceptions, and public health impact.
Results: Few SCS were in rural/small population centres across Canada, with most being concentrated in the provinces of British Columbia and Ontario. Delivery models varied (e.g. hours of operation, supported consumption methods, funding), and included fixed-site, mobile and virtual service models. Many programs offered auxiliary services including harm reduction and safer sex supply distribution, naloxone distribution, HIV/HCV testing, education and referrals to external health/social services. Barriers to service access included increased community level stigma, physical accessibility, and local policy/regulatory environment. Lived experience of staff was identified as facilitating access.
Conclusion: Further research is needed to facilitate SCS scale up to smaller population centres. Moving beyond traditional fixed site models and leveraging informal peer networks has the potential to enhance access to supervised consumption in more rural and remote places and in other lower resource settings.
Download abstract Download poster