A rapid assessment of the impact of the COVID-19 pandemic on supervised consumption services in Canada

The COVID-19 pandemic and associated public health measures have increased overdose risk for people who use drugs. Since the start of the pandemic, provinces across Canada have reported record high overdose deaths, likely due to illegal drug market disruptions, physical distancing, and self-isolation measures. These measures may result in delayed intervention in the case of overdose, as more people may choose to consume their drugs alone. These increased overdose risks are occurring in the context of decreased access to health services like supervised consumption services (SCS), which have had to adapt to prevent risks of COVID-19 transmission amongst staff and participants. SCS are a core component of Canada's overdose response, and there are currently 38 federally-sanctioned SCS in Canada. SCS originally developed under a harm reduction approach to substance use and provide safe spaces where people consume drugs, are monitored for overdose, and receive access to health and social care. Ensuring access to SCS during the COVID-19 pandemic is thus important for addressing overdose risk, but we do not know the extent of service disruptions in Canada. Therefore, we aim to: (1) systematically describe SCS use patterns prior to, and after the onset of the COVID-19 pandemic; (2) compare impacts of COVID-19 on SCS across different service models and regions; (3) assess SCS staff perspectives on how the COVID-19 pandemic is shifting care for people who use drugs; and (4) outline staff-identified solutions for ensuring SCS access during the pandemic and other crises. Our findings and knowledge translation resources will directly support SCS in adapting to COVID-19, help ensure ongoing and equitable access to these services, and address the combined harms of overdose and COVID-19 for people who use drugs regionally and nationally.