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The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19 McCrae, Karen; Glegg; Goyer, Marie-Éve; Le Foll, Bernard; Brar, Rupinder; Sutherland, Christy; Fairbairn, Nadia

Abstract

Background The dual COVID-19 and overdose emergencies amplified strain on healthcare systems tasked with responding to both. One downstream consequence of the pandemic in the USA and Canada was a surge in drug overdoses resulting from public health-restricted access to services and an increasingly toxic unregulated drug supply. This study aimed to describe changes implemented by programs prescribing pharmaceutical alternatives to the drug supply during the early stages of the COVID-19 pandemic. Methods An environmental scan used surveys and qualitative interviews with service providers across Canada to examine pharmaceutical alternative prescribing practices and programs before and during the pandemic. This study summarized the nature, frequency, and reasons for pandemic-driven service delivery changes using directed content analysis, counts, and thematic analysis. Results Eighty-two of the 103 participating sites reported 1193 unique changes in physical space (368), client protocols (347), program operations (342), ancillary services (127), and staffing (90). Four qualitative themes describing the reasons for these changes emerged, namely (1) decreasing risk of COVID-19 infection; (2) decreasing risk of overdose; (3) prioritizing acute care of COVID-19 patients; and (4) improving client access to treatment. Conclusions While most changes were aimed at decreasing risk of COVID-19 infection, some were found to be at odds with the measures needed to combat the overdose crisis; others met dual objectives of decreased risk of both overdose and infection. Further research should examine which changes should be kept or reversed once COVID-19-related public health measures are lifted.

Item Metadata

Title
The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19
Creator
McCrae, Karen; Glegg; Goyer, Marie-Éve; Le Foll, Bernard; Brar, Rupinder; Sutherland, Christy; Fairbairn, Nadia
Contributor
British Columbia Centre on Substance Use; Vancouver Coastal Health Authority
Publisher
BioMed Central
Date Issued
2022-07-14
Description
Background The dual COVID-19 and overdose emergencies amplified strain on healthcare systems tasked with responding to both. One downstream consequence of the pandemic in the USA and Canada was a surge in drug overdoses resulting from public health-restricted access to services and an increasingly toxic unregulated drug supply. This study aimed to describe changes implemented by programs prescribing pharmaceutical alternatives to the drug supply during the early stages of the COVID-19 pandemic. Methods An environmental scan used surveys and qualitative interviews with service providers across Canada to examine pharmaceutical alternative prescribing practices and programs before and during the pandemic. This study summarized the nature, frequency, and reasons for pandemic-driven service delivery changes using directed content analysis, counts, and thematic analysis. Results Eighty-two of the 103 participating sites reported 1193 unique changes in physical space (368), client protocols (347), program operations (342), ancillary services (127), and staffing (90). Four qualitative themes describing the reasons for these changes emerged, namely (1) decreasing risk of COVID-19 infection; (2) decreasing risk of overdose; (3) prioritizing acute care of COVID-19 patients; and (4) improving client access to treatment. Conclusions While most changes were aimed at decreasing risk of COVID-19 infection, some were found to be at odds with the measures needed to combat the overdose crisis; others met dual objectives of decreased risk of both overdose and infection. Further research should examine which changes should be kept or reversed once COVID-19-related public health measures are lifted.
Subject
Safe supply; Substance use; Harm reduction; Injectable opioid agonist treatment; COVID-19 pandemic; Canada
Genre
Article
Type
Text
Language
eng
Date Available
2022-11-22
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0422017
URI
http://hdl.handle.net/2429/83181
Affiliation
Medicine, Faculty of; Non UBC; Medicine, Department of
Citation
Harm Reduction Journal. 2022 Jul 14;19(1):77
Publisher DOI
10.1186/s12954-022-00657-x
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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DSpace

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Rights

Attribution 4.0 International (CC BY 4.0)