I don’t chase drugs anymore and I’m not dead': The Impact of Safer Opioid Supply Programs in Ontario Canada on Client’s Health and Drug Use

Over 25,000 Canadians have died from opioid overdose since 2016. The ongoing opioid overdose crisis is driven by the volatility of an unregulated drug supply contaminated with fentanyl, increasingly potent fentanyl analogues and recently benzodiazepines. Although opioid agonist treatments like methadone reduce the risk of overdose death and improve health outcomes, more than half of patients who start methadone drop out within one year. Safer opioid supply programs (SSPs) that include ‘off label’ prescriptions of pharmaceutical-grade opioids for take-home dosing have recently been funded by Health Canada as an alternative to toxic unregulated opioids.

Between February and October 2021, we examined the implementation and adaption of SSP across four sites in Ontario, Canada’s most populous province. These programs use a primary care model and serve marginalized communities. We used a mixed-methods design including semi-structured interviews with clients, service providers, and pharmacists coupled with sociodemographic surveys. Surveys also included clients’ substance use behaviours. We purposively sampled women, racialized people, and clients with a history of a positive HIV or hepatitis C diagnosis. Thematic analysis was collaboratively conducted in MAXQDA and frequency analysis was conducted in SPSS v28.

This presentation will describe the results from the n=53 client interviews (mean age 47 years [SD 9.5], 57% male, 13% HIV+ and 19% self-identified Indigenous). Our results indicate multifaceted pathways that resulted in improved self-reported health outcomes among clients including reduced injecting behaviour, decreased cravings for illicit opioids and less criminal activity, coupled with increased stability (e.g., housing security), improved trust in health care, better mental health, and renewed self-identity. Importantly, most clients reported that the intervention saved their life because of the reduced frequency of overdoses.

Clients reported that SSPs were life-saving interventions. Findings indicated that SSPs improved clients’ health outcomes and increased engagement in health services among people who use opioids.