Evidence map›Paper›PMID 38444035›Full record

ArticleSubstance abuse treatment, prevention, and policy2024

Prescribed safer supply during dual public health emergencies: a qualitative study examining service providers perspectives on early implementation.

J McCall, H Hobbs, C Ranger, F Cameron, H Stuart, J Nelken, J Majalahti, K Urbanoski, G Kolla, J LeMaistre and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Substance abuse treatment, prevention, and policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.3field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

J McCallUniversity of Victoria, PO Box 1700, Stn CSC, Victoria, BC, V8W 2Y2, Canada.
H HobbsAVI Health and Community Services, 713 Johnson Street, Victoria, BC, V8W 1M8, Canada.
C RangerAVI Health and Community Services, 713 Johnson Street, Victoria, BC, V8W 1M8, Canada.
F CameronSOLID Outreach, 1056 North Park St, Victoria, BC, Canada.
H StuartSOLID Outreach, 1056 North Park St, Victoria, BC, Canada.
J NelkenSOLID Outreach, 1056 North Park St, Victoria, BC, Canada.
J MajalahtiSOLID Outreach, 1056 North Park St, Victoria, BC, Canada.
K UrbanoskiUniversity of Victoria, PO Box 1700, Stn CSC, Victoria, BC, V8W 2Y2, Canada.
G KollaUniversity of Victoria, PO Box 1700, Stn CSC, Victoria, BC, V8W 2Y2, Canada.
J LeMaistreAVI Health and Community Services, 713 Johnson Street, Victoria, BC, V8W 1M8, Canada.
K ToombsAVI Health and Community Services, 713 Johnson Street, Victoria, BC, V8W 1M8, Canada.
R HerriotVictoria SAFER Program, 1806 Cook Street, Victoria, BC, V8W 1M8, Canada.
Bernie PaulyUniversity of Victoria, PO Box 1700, Stn CSC, Victoria, BC, V8W 2Y2, Canada. bpauly@uvic.ca.
Victoria Park · CAUniversity of Victoria · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWithin North America and worldwide, drug related overdoses have increased dramatically over the past decade. COVID-19 escalated the need for a safer supply to replace unregulated substances and to reduce toxicity and overdoses. Service providers play an integral role in the delivery of safer supply but there is little empirical evidence that conceptualizes effective safer supply from their perspectives. This study explored early implementation and impacts of a safer supply program, capturing the perspectives of an interdisciplinary team of service providers on tensions and issues encountered in the development of the SAFER program.

methodsUsing a community-based participatory approach, we conducted individual interviews with program providers (n = 9). The research team was composed of researchers from a local drug user organization, a local harm reduction organization, and academic researchers. The Consolidated Framework for Implementation Research (CFIR) informed the interview guide. Data was analyzed using thematic analysis.

resultsThere are six themes describing early implementation: (1) risk mitigation prescribing as context for early implementation; (2) developing SAFER specific clinical protocols; (3) accessibility challenges and program innovations; (4) interdisciplinary team and wraparound care; (5) program tensions between addiction medicine and harm reduction; (6) the successes of safer supply and future visions.

conclusionEarly implementation issues and tensions included prescriber concerns about safer supply prescribing in a highly politicized environment, accessibility challenges for service users such as stigma, encampment displacement, OAT requirements, program capacity and costs, and tensions between addiction medicine and harm reduction. Navigating these tensions included development of clinical protocols, innovations to reduce accessibility challenges such as outreach, wraparound care, program coverage of medication costs and prescribing safer supply with/without OAT. These findings contribute important insights for the development of prescribed safer supply programs.

Indexed as

Addiction MedicineCOVID-19Drug OverdoseCommunity ParticipationEmergenciesHumansPublic HealthHarm reductionImplementation scienceOverdosePrescribed safer supplyQualitative researchSafer supplyService providersToxic drug crisis

Identifiers

PMID38444035
PMCPMC10913403
OpenAlexW4392469254

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.