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Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada

OBJECTIVES: Fentanyl has contributed to a sharp rise in the toxicity of the unregulated drug supply and fatal overdoses in Canada. It has also changed injection practices. Injection frequency has increased as a result and so has equipment sharing and health-related risks. The aim of this analysis wa...

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Autores principales: Gagnon, Marilou, Rudzinski, Katherine, Guta, Adrian, Schmidt, Rose A., Kryszajtys, David T., Kolla, Gillian, Strike, Carol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10303300/
https://www.ncbi.nlm.nih.gov/pubmed/37380995
http://dx.doi.org/10.1186/s12954-023-00817-7
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author Gagnon, Marilou
Rudzinski, Katherine
Guta, Adrian
Schmidt, Rose A.
Kryszajtys, David T.
Kolla, Gillian
Strike, Carol
author_facet Gagnon, Marilou
Rudzinski, Katherine
Guta, Adrian
Schmidt, Rose A.
Kryszajtys, David T.
Kolla, Gillian
Strike, Carol
author_sort Gagnon, Marilou
collection PubMed
description OBJECTIVES: Fentanyl has contributed to a sharp rise in the toxicity of the unregulated drug supply and fatal overdoses in Canada. It has also changed injection practices. Injection frequency has increased as a result and so has equipment sharing and health-related risks. The aim of this analysis was to explore the impact of safer supply programs on injection practices from the perspective of clients and providers in Ontario, Canada. METHODS: The data set included qualitative interviews with 52 clients and 21 providers that were conducted between February and October 2021 across four safer supply programs. Interview excerpts discussing injection practices were extracted, screened, coded and then grouped into themes. RESULTS: We identified three themes, each theme corresponding to a change in injection practices. The first change was a decrease in the amount of fentanyl used and a decrease in injection frequency. The second change involved switching to injecting hydromorphone tablets instead of fentanyl. Finally, the third change was stopping injecting altogether and taking safer supply medications orally. CONCLUSION: Safer supply programs can contribute to reducing injection-related health risks in addition to overdose risks. More specifically, they have the potential to address disease prevention and health promotion gaps that stand-alone downstream harm reduction interventions cannot address, by working upstream and providing a safer alternative to fentanyl.
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spelling pubmed-103033002023-06-29 Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada Gagnon, Marilou Rudzinski, Katherine Guta, Adrian Schmidt, Rose A. Kryszajtys, David T. Kolla, Gillian Strike, Carol Harm Reduct J Research OBJECTIVES: Fentanyl has contributed to a sharp rise in the toxicity of the unregulated drug supply and fatal overdoses in Canada. It has also changed injection practices. Injection frequency has increased as a result and so has equipment sharing and health-related risks. The aim of this analysis was to explore the impact of safer supply programs on injection practices from the perspective of clients and providers in Ontario, Canada. METHODS: The data set included qualitative interviews with 52 clients and 21 providers that were conducted between February and October 2021 across four safer supply programs. Interview excerpts discussing injection practices were extracted, screened, coded and then grouped into themes. RESULTS: We identified three themes, each theme corresponding to a change in injection practices. The first change was a decrease in the amount of fentanyl used and a decrease in injection frequency. The second change involved switching to injecting hydromorphone tablets instead of fentanyl. Finally, the third change was stopping injecting altogether and taking safer supply medications orally. CONCLUSION: Safer supply programs can contribute to reducing injection-related health risks in addition to overdose risks. More specifically, they have the potential to address disease prevention and health promotion gaps that stand-alone downstream harm reduction interventions cannot address, by working upstream and providing a safer alternative to fentanyl. BioMed Central 2023-06-28 /pmc/articles/PMC10303300/ /pubmed/37380995 http://dx.doi.org/10.1186/s12954-023-00817-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gagnon, Marilou
Rudzinski, Katherine
Guta, Adrian
Schmidt, Rose A.
Kryszajtys, David T.
Kolla, Gillian
Strike, Carol
Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title_full Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title_fullStr Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title_full_unstemmed Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title_short Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada
title_sort impact of safer supply programs on injection practices: client and provider experiences in ontario, canada
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10303300/
https://www.ncbi.nlm.nih.gov/pubmed/37380995
http://dx.doi.org/10.1186/s12954-023-00817-7
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