Investigating access to and outcomes from supervised drug consumption services in British Columbia before and during the COVID-19 pandemic

Canada continues to face two public health epidemics. The opioid overdose crisis continues to account for considerable suffering and death. This is true of British Columbia where a public health emergency was declared in response to the overdose crisis, and where over 6000 people have died of overdose since 2016. More recently, COVID-19 emerged and is responsible for significant illness, hospitalizations, and deaths. Unfortunately, it has now become apparent that the emergence of COVID-19 has worsened the overdose epidemic, due to a range of factors, including restrictions imposed to reduce COVID-19 transmission (e.g., social distancing, isolation) and disruptions in access to overdose prevention programs. Supervised drug consumption services (SCS) are settings where people can consume drugs under the supervision of healthcare professionals who provide emergency response in the event of an overdose. Existing research suggests that SCS reduce the risk of overdose death, and to date, no one has ever died of an overdose in an SCS. While there is now growing concern that access to SCS has been compromised during the COVID-19 epidemic, little is known about how COVID-19 may be impacting access to and outcomes from SCS. To better understand these impacts and inform policy and practice specific to SCS, we propose to undertake research on SCS and COVID-19 in two settings in British Columbia (Vancouver and Surrey). We aim to use our existing research infrastructure to examine changes in SCS use over time (pre-post COVID-19), identify those who are and are not accessing SCS, and specific barriers to SCS access. We will also seek to determine how changes in SCS use during the COVID-19 era have affected key outcomes from SCS implementation, including changes in risk behaviours, addiction treatment use, and the use of public spaces for injecting. Lastly, we also use this project to generate quality data that can be used by others in in modelling and cost-effectiveness studies.