Integrated Supervised Injection Services Evaluation in Toronto, Ontario
Supervised injection services (SIS) have been demonstrated to reduce overdose fatalities and infectious disease risks among people who inject drugs (PWID), while facilitating access to substance use treatment. In response to Canada’s opioid overdose crisis, SIS are expanding across the country. In Ontario, recently-opened SIS are integrated within existing healthcare agencies, with the goal of promoting access to services that address the health and social needs of PWID.
While the evidence base for stand-alone SIS models is strong, research on the effectiveness of integrated models such as those being implemented in Ontario is underdeveloped.
It is believed that the integration of SIS within community health agencies can facilitate engagement of PWID with the continuum of services they offer, including primary care, counselling, mental health, health promotion, and employment and housing supports. Further, feasibility research has suggested these models are preferable to standalone models in settings like Toronto where drug use is relatively geographically dispersed.
Drawing on a longitudinal cohort of PWID (including SIS users and non-users) and administrative data linkages, the CDPE will be evaluating the uptake and impacts of three integrated SIS in Toronto, at Parkdale Queen West Community Health Centre (Queen West site), South Riverdale Community Health Centre, and The Works at Toronto Public Health. The study is being conducted in partnership with the integrated SIS and peer advisors/research associates.
This research will generate information on the effectiveness of integrated SIS, ongoing barriers to access, and opportunities to optimize health services and outcomes for PWID.
Canadian Institutes of Health Research
St. Michael’s Hospital Foundation
British Columbia Centre on Substance Use | Ontario HIV Treatment Network | Ontario Ministry of Health & Long-Term Care | Parkdale Queen West Community Health Centre | Public Health Ontario | Sandy Hill Community Health Centre | South Riverdale Community Health Centre | The Works | Toronto Public Health | University of Ottawa
The CDPE is leading a study to evaluate the impact of safer opioid supply programs in Toronto, Ontario.View
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As supervised consumption services (SCS) are scaled-up across Canada, information on those who require help injecting is necessary to inform equitable service uptake. We characterised the sociodemographic, structural and drug use correlates of needing help injecting among a cohort of people who inject drugs in Toronto, Canada.View
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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
Supervised Consumption Service Use and Recent Non-Fatal Overdose among People Who Inject Drugs in Toronto, Canada
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This commentary emphasizes the need for research on supervised injection services to move from asking whether such services are effective to asking whether, how, and under what conditions their benefits can be maximized.View