Securing Safe Supply During COVID-19 and Beyond: Scoping Review and Knowledge Mobilization

https://cihr-irsc.gc.ca/e/documents/HERDER_Initial-Knowledge-Synthesis_Draft-2020-06-22.pdf Creating a "safe supply" of drugs has the potential to reduce a variety of harms suffered by People Who Use Drugs (PWUDs), including non-fatal and fatal overdoses associated with Canada's ongoing opioid crisis. The onset of the COVID-19 pandemic, and related social distancing measures, has complicated PWUDs ability to access the pharmacological substances they need, placing them at increased risk of harm from withdrawal and/or toxicity from unsafe 'street' sources of drugs. In the context of COVID-19, the college of pharmacists has lifted the requirement of triplicate prescriptions for controlled substances, making it easier for physicians and pharmacists to serve people in our public state of emergency. Addiction clinics have also developed more leniency for 'take-home' doses of medication (such as opioid agonist therapy) to encourage social isolation and support people in quarantine. However, access to a safe supply of opioids remains elusive for many PWUDs in Canada for reasons that are presently unclear. Integrating the expertise of PWUDs, clinicians, scientists, and legal scholars, the core aim of our project is to find ways to facilitate access to a safe supply of drugs in the context of the COVID-19. We will: 1) identify best practices for securing a safe supply for PWUDs, focused in part on how "safe" supply may be contextually conditioned; and 2) develop a set of recommendations and strategies to encourage the uptake of safe supply across Canada. These will take into account factors including the circumstances of PWUDs who have recently been released from prison and additional challenges related to geography, homelessness, poverty, race, and/or gender. Incorporating the lived experiences and expertise of PWUDs directly into our research, our team's combined medical, scientific, and legal training has the capacity to make sense of-and act upon-the evidence on how to provide access to a safe supply of drugs in the context COVID-19 pandemic and beyond.