Ontario's Opioid Drug Observatory: Generating evidence on the evolving opioid crisis to inform and evaluate drug policy and clinical practice in Ontario

The harms related to opioid use continue to climb across Canada, and the arrival of the COVID-19 pandemic has further worsened this crisis, with many communities reporting record numbers of harms. As the factors influencing opioid-related harm have shifted in the past decade, so has the clinical response, with the arrival of newer treatment options and harm reduction services. As Canada grapples with challenges to providing accessible services in the midst of this overdose-COVID-19 syndemic, more research is urgently needed to monitor and evaluate the evolving overdose crisis. In 2017, the Ontario Opioid Drug Observatory (OODO) was funded to inform and evaluate opioid policy across Ontario. As this crisis has worsened, the need for timely, high quality evidence to inform policy has increased. Through linkage of a broad repository of health care data, our proposed work will describe provincial patterns of opioid use, harms, and access to treatment and harm reduction services; assess the effectiveness and accessibility of treatment and harm reduction services; and identify modifiable factors that can influence patterns of healthcare use and patient outcomes among people experiencing serious opioid-related harms. The proposed research questions have been guided by a diverse group of patients, researchers, clinicians, harm reduction workers, and policy-makers who comprise the OODO Steering Committee. This committee will continue to oversee this work to ensure broad relevance, uptake and dissemination. As Canadian policymakers are faced with the challenge of rapidly adapting to a changing overdose crisis that is being worsened by the COVID-19 pandemic, our work will provide a comprehensive understanding of the crisis in Ontario. Our team of experts will optimize the use of high-quality datasets to inform and evaluate national and provincial prescribing policies and clinical decision-making with the potential for enormous public health impact over the coming years.