T-DOT (Toronto Disparities, Overdose and Treatment), formerly OiSIS
T-DOT (Toronto Disparities, Overdose and Treatment) is an ongoing cohort study that started in 2018 (formerly OiSIS) of people who use drugs, looking at supervised consumption sites, drug checking, treatment, and the continuum of care. Sub-studies include: Injectable Opioid Agonist Treatment (iOAT) and Safer Opioid Supply (SOS or Prescribed Alternatives) program evaluations in Toronto.
Project Contents
Please note: As of January 2025, CDPE will only be conducting Follow Up interviews for existing study participants. We are putting a temporary pause on accepting any new study participants at this time.
We will provide on-going updates regarding this temporary change. Once we open the survey interviews for new participants, we will share this information broadly with our partner sites and via social media
Overview
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.
Financial Supporters
Canadian Institutes of Health Research
St. Michael’s Hospital Foundation
New Frontiers in Research Fund
Partners
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
Project Contact
Jolene Eeuwes
Jolene.Eeuwes@unityhealth.to
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Safer Opioid Supply Programs Evaluation in Toronto, Ontario
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Integrating Supervised Consumption into a Continuum of Care for People Who Use Drugs
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.
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