Utilizing Health Promotion to Respond to the Drug Toxicity Public Health Emergency: A Cross-Provincial Comparative Analysis of Opioid Agonist Therapy Policy during the COVID-19 Pandemic

The principles and practices of health promotion provide valuable ways for responding to major public health emergencies. Opioid use is a public health emergency across North America with high risks of overdose and death. This crisis became even worse during the COVID-19 pandemic, another major public health emergency. Opioid use disorder (OUD), also called opioid addiction, is a condition where people continue to use opioids despite the negative consequences. OUD can be treated with drugs such as methadone and buprenorphine, which are called opioid agonist therapy (OAT). However, even before the pandemic, there were strict rules for how OAT was delivered in Canada, making people with OUD feel that they had no control over their own care. To keep up physical distancing during the pandemic, changes were made in how OAT was delivered to people, such as taking the medications at home, allowing pharmacists to renew prescriptions, providing care virtually, and doing less urine drug testing. Some areas have shown success with this less strict approach to OAT, while other areas have returned to the more strict approach from before the pandemic. Policymakers in different Canadian provinces need more information to better understand how OAT services changed during the pandemic and how OAT can continue to change in order to promote the health of people with OUD. To learn this information, our research will compare policies across all Canadian provinces by reading different policy documents, and interviewing people such as people with OUD, policymakers, public health leaders, healthcare professionals, and researchers. This will help find ways to improve how OAT services are delivered, and create policies for more accessible and fair treatment using strategies that allow people with OUD to have more control over their own health. This information will also let policymakers from different provinces learn from each other and make better decisions to tackle the opioid crisis.