Evaluation of supervised consumption services in Montreal in the context of COVID-19

Supervised consumption services (SCS) aim to reduce the harms of injection drug use by providing a controlled environment for people to inject drugs, with emergency response in the event of an overdose, sterile injection supplies, drug checking, counseling, referrals, and other supports. The ongoing COVID-19 pandemic has disrupted the operations of these vital services, and fatal overdoses have dramatically increased in Canada since the onset of the health crisis. This study will examine the impact of COVID-19 on supervised consumption services and their attendees. First, we will compare service usage before and during COVID-19 by looking at the number of visits to the services, the number of new attendees, the number of on-site overdoses, and the types of substances being consumed, among other factors. We will use this data to develop an idea of the different groups of people who use supervised consumption services, and to assess whether attendee groups have changed as a result of the pandemic. Building on these results, we will model the impact of service changes on future overdose rates in the population, and project the potential to avert these harms by improving retention and engagement with supervised consumption services in the future. This study will generate insights into the functioning of supervised consumption services during the COVID-19 pandemic. Our results will help develop a clearer picture of attendee profiles before and during the pandemic, supporting supervised consumption services in targeting underrepresented groups. These findings will support recommendations for supervised consumption service operations and policies in the context of health crises, with the ultimate aim of reducing overdose rates both within and beyond supervised consumption sites. Guidelines and best practices developed in response to the pandemic will also serve to prepare knowledge users for future public health emergencies.