ArticleSubstance abuse treatment, prevention, and policy2024
Access and barriers to safer supply prescribing during a toxic drug emergency: a mixed methods study of implementation in British Columbia, Canada.
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 5 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Safer opioid supply clients' values and preferences: a systematic review and thematic synthesis of qualitative research.BMJ mental health · 2025Pooled it
- Safer supply deprescribing during a toxic drug poisoning crisis in Vancouver, Canada.Drug and alcohol dependence · 2026Article
- Review
- The characteristics and experiences of parents accessing prescribed safer supply in BC, 2020-2021.Harm reduction journal · 2026Article
- Characterizing changes to harm reduction site operations in British Columbia following the implementation of the decriminalization of drugs: Findings from a provincial survey.Harm reduction journal · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundIn March 2020, British Columbia, Canada, introduced prescribed safer supply involving the distribution of pharmaceutical grade alternatives to the unregulated toxic drug supply. Prior research has demonstrated positive impacts on overdose mortality, but with limited reach to people who use substances. Objectives of this study were to (1) identify barriers to accessing safer supply prescribing among people who use substances; and (2) determine whether and how barriers differed between people with and without prescriptions, and between urban and rural settings.
methodsWe conducted a participatory mixed-methods study guided by the Consolidated Framework for Implementation Research. Participants (≥ 19 years old) had received a safer supply prescription or were seeking one (survey n = 353; interviews n = 54).
resultsParticipants who had a prescription were more likely to be living in a large urban centre, compared to medium/smaller centres and rural areas (78.5% vs. 65.8%, standardized mean difference = 0.286). Participants who did not have a prescription were more likely to report an array of structural, interpersonal, and health-related barriers (compared to those who had a prescription). In interviews, participants linked experiences of barriers to stigma and criminalization, low availability of services, lack of information and prescribers, not being able to get what they need, and anxieties, worries and doubts stemming from personal circumstances. There were no notable differences between large urban centres and medium/smaller centres and rural areas in the presence of specific types of barriers.
conclusionsFindings demonstrate restricted access to safer supply prescribing outside of large urban centres and provide future targets for enhancing implementation. Attention is needed to promote equity and counter systemic barriers in the implementation of responses to the ongoing toxic drug emergency.
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Registered trials
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.