COVID-19 Rapid Assessment
The COVID-19 pandemic has exacerbated the overdose crisis in Toronto, with record increases in the number of overdose fatalities. Mandated physical distancing and service closures have limited the capacity of clinicians and service providers to provide care and support for people who inject drugs.
In response, the CDPE is leading a rapid assessment of the impact of the COVID-19 pandemic on people who inject drugs in Toronto, including clinical and social outcomes, service utilization, and trends in the unregulated drug supply. Unhoused or underhoused subpopulations of people who inject drugs are a focus of this assessment, as they are disproportionately at risk of overdose, are often immunocompromised, and can face serious chronic conditions – putting them at higher risk for SARS-CoV-2 infections and severe COVID-19 disease.
Building upon the Integrated Supervised Injection Services (OiSIS) Evaluation led by the CDPE, this rapid assessment includes quantitative surveys and qualitative interviews with cohort participants about the effects of COVID-19 on their lives. In addition, the rapid assessment tracks participant clinical outcomes over time through an administrative health data linkage with ICES. We are also analyzing service utilization data from harm reduction services across the city, including Toronto’s drug checking service. Using mixed methods approaches, the rapid assessment will yield critical findings on the social and public health consequences of COVID-19 on people who inject drugs to inform improvements to policy and clinical practice.
Canadian Institutes of Health Research | Canadian Research Initiative in Substance Misuse | St. Michael’s Hospital Foundation
British Columbia Centre on Substance Use| Centre for Addiction and Mental Health | Canadian Research Initiative in Substance Misuse | Moss Park Consumption and Treatment Service | Parkdale Queen West Community Health Centre | South Riverdale Community Health Centre | St. Michael’s Hospital | The Works at Toronto Public Health
Dr. Dan Werb
The CDPE is leading a study to evaluate the impact of integrating supervised injection services within community healthcare agencies in Toronto, Ontario.View
Evaluating interventions to facilitate opioid agonist treatment access among people who inject drugs in Toronto, Ontario during COVID-19 pandemic restrictions
In March 2020, following a provincial COVID-19 emergency declaration, modifications to opioid agonist treatment (OAT) were introduced in Ontario, Canada to promote treatment access amid the pandemic and ongoing opioid overdose crisis. Our objectives were to evaluate the effects of these modifications on OAT enrollment and on receipt of take-home doses and the frequency of urine drug screening among OAT-enrolled participants, as well as to investigate concurrent pre- and post-implementation trends in opioid-related overdoses and all-cause mortality.View
The Ontario Integrated Supervised Injection Services Cohort Study of People Who Inject Drugs in Toronto, Canada (OiSIS-Toronto): Cohort Profile
The Ontario Integrated Supervised Injection Services cohort in Toronto, Canada (OiSIS-Toronto) is an open prospective cohort of people who inject drugs established to evaluate the impacts of supervised consumption services integrated within three community health agencies on health status and service use.View
Xylazine detected in unregulated opioids and drug administration equipment in Toronto, Canada: clinical and social implications
We report the first detection of the psychoactive veterinary compound xylazine in Toronto, the largest urban center in Canada, by the city’s drug checking service.View
Preliminary Patterns in Circumstances Surrounding Opioid-Related Deaths in Ontario during the COVID-19 Pandemic
The Ontario Drug Policy Research Network, the Office of the Chief Coroner for Ontario/the Ontario Forensic Pathology Service, Public Health Ontario, and the CDPE have published a report analyzing trends in opioid-related deaths and comparing circumstances of death between two groups: a COVID-19 pandemic cohort and a pre-pandemic cohort.View