Perspectives Pathways and Priorities of People with Lived and Living Experience of Substance Use: Informing Policies (P5 Project YXE)

P5 Project YXE research aims to understand localized harms of substance use in the context of an ongoing national drug-toxicity and overdose crisis. P5 Project YXE is the first of its kind in the province, aiming to mobilize the voices of people with lived and living experience (PWLLE) of substance use across three socioeconomic groupings to enhance pathways for care and enact policy change. The study embeds PWLLE across the research team and in the research process, to enhance understanding of community-level substance use patterns.

The project engaged a patient-oriented research (POR) and community-based participatory action research (CBPAR) approach to address three study questions: 1) What do the perspectives of PWLLE reveal about the current nature of substance use services in Saskatchewan? 2) What are the actual pathways people navigate for services? 3) What are the PWLLE priorities for services and policy change? The team achieved a virtually mediated community-based data collection process during the pandemic and completed 42, hour-long interviews, across three socioeconomic groups. Analysis is ongoing.

Early analysis suggests terminology (harm reduction, treatment, recovery) holds little meaning for individuals seeking substance use related support services. A sense of ‘belonging’ influences willingness to access service. Stigma is understood by PWLLE to threaten employment and educational opportunities, leading to hesitation by employed persons to utilize publicly funded health services. Structural limitations (mid-day appointments conflicting with employment hours) and stigma appear to be influencing those with financial means toward selecting private care options (perceived to provide flexibility and enhanced privacy). Thematic analysis will address the relationships between perceptions, service utilization, and policy adaptation to inform knowledge sharing.

Structural adaptation of publicly funded substance use services can be achieved through policy change at the community, civic and provincial level to better meet the needs of people who use substances in Saskatchewan.