Responding to dual public health crises in the Emergency Department: Advancing patient-centered care for people who use opioids during COVID-19

The COVID-19 pandemic has collided with Canada's ongoing overdose emergency to exacerbate harms for people who use opioids. Border closures and travel restrictions are disrupting the illegal drug supply, increasing adulteration and unpredictability. Public health measures to reduce the spread of COVID-19 are creating economic and psychological strain, and physical distancing and health service closures are reducing available supports for people who use opioids. Taken together, these challenges are increasing risk of overdose morbidity and mortality across Canada. Hospital emergency departments are an important setting for reducing opioid-related harm. However, the onset of COVID-19 has resulted in major shifts in how they care for patients. Our research project adopts a mixed method, patient-oriented approach to (1) describe the impacts of COVID-19 on opioid-related emergency department visits; (2) analyze how emergency department care for patients who use opioids has changed during the pandemic; (3) assess emergency department patient and staff perspectives on receiving or providing opioid-related care during COVID-19; and (4) develop training materials and policy and practice recommendations to prepare emergency departments to deliver patient-centred care for people who use opioids during and after COVID-19 and other future crises. Project findings and knowledge translation materials will directly support emergency departments in responding to dual public health emergencies, help ensure equitable healthcare access, and mitigate the combined harms of overdose and COVID-19 for people who use opioids, locally, provincially, and nationally.