The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation
The COVID-19 pandemic and related restrictions exacerbated Canada's ongoing drug toxicity overdose crisis. Opioid agonist therapy (OAT), safer opioid supply (SOS), and supervised consumption sites (SCS) are interventions that aim to reduce risk of morbidity and mortality from drug toxicity and...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-12-01
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| Series: | SSM: Qualitative Research in Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321525000472 |
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| author | Gillian Kolla Jeanette M. Bowles Katie Upham Hannah Ali Seff Pinch Hafza Majid Laila Bellony Dan Werb Sanjana Mitra |
| author_facet | Gillian Kolla Jeanette M. Bowles Katie Upham Hannah Ali Seff Pinch Hafza Majid Laila Bellony Dan Werb Sanjana Mitra |
| author_sort | Gillian Kolla |
| collection | DOAJ |
| description | The COVID-19 pandemic and related restrictions exacerbated Canada's ongoing drug toxicity overdose crisis. Opioid agonist therapy (OAT), safer opioid supply (SOS), and supervised consumption sites (SCS) are interventions that aim to reduce risk of morbidity and mortality from drug toxicity and were affected by COVID-19. Between September and October 2020, we conducted qualitative interviews with 24 people who inject drugs receiving services at community harm reduction programs in Toronto, Canada to examine the health and socioeconomic impacts of COVID-related service disruptions. Participants who were already receiving OAT and SOS prior to the start of pandemic reported high levels of continuity of care when pandemic measures were implemented, with medical appointments switching to telemedicine. Participants reported easy access to harm reduction supplies, but those accessing SCS reported increased wait times due to COVID-related capacity restrictions that reduced the number of injection spaces available due to physical distancing requirements. Participants reported extreme difficulty accessing shelter beds and food insecurity due to the closure of drop-in programs, food banks, and food distribution programs and noted the deep impacts these changes had on their health and socioeconomic well-being. Disruption in service delivery of shelters and food programs reveal the need for adaptation of strategies to ensure service continuity. Preparedness planning for future public health emergencies can benefit from analysis of lessons learned, as continuity of care was successfully ensured in OAT, SOS and harm reduction service delivery. |
| format | Article |
| id | doaj-art-c2ab97b8fdcf4e599c18d39050032657 |
| institution | OA Journals |
| issn | 2667-3215 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-c2ab97b8fdcf4e599c18d390500326572025-08-20T02:05:09ZengElsevierSSM: Qualitative Research in Health2667-32152025-12-01810056910.1016/j.ssmqr.2025.100569The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigationGillian Kolla0Jeanette M. Bowles1Katie Upham2Hannah Ali3Seff Pinch4Hafza Majid5Laila Bellony6Dan Werb7Sanjana Mitra8Faculty of Medicine, Memorial University, St. John's, Canada; Centre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Corresponding author. Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL Canada, A1B 3V6.British Columbia Centre on Substance Use, Vancouver, CanadaCentre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, CanadaCentre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, CanadaSouth Riverdale Community Health Centre, Toronto, CanadaParkdale Queen West Community Health Centre, Toronto, CanadaParkdale Queen West Community Health Centre, Toronto, CanadaCentre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Division of Infectious Diseases & Global Public Health, University of California, San Diego, La Jolla, United StatesCentre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Division of Infectious Diseases & Global Public Health, University of California, San Diego, La Jolla, United StatesThe COVID-19 pandemic and related restrictions exacerbated Canada's ongoing drug toxicity overdose crisis. Opioid agonist therapy (OAT), safer opioid supply (SOS), and supervised consumption sites (SCS) are interventions that aim to reduce risk of morbidity and mortality from drug toxicity and were affected by COVID-19. Between September and October 2020, we conducted qualitative interviews with 24 people who inject drugs receiving services at community harm reduction programs in Toronto, Canada to examine the health and socioeconomic impacts of COVID-related service disruptions. Participants who were already receiving OAT and SOS prior to the start of pandemic reported high levels of continuity of care when pandemic measures were implemented, with medical appointments switching to telemedicine. Participants reported easy access to harm reduction supplies, but those accessing SCS reported increased wait times due to COVID-related capacity restrictions that reduced the number of injection spaces available due to physical distancing requirements. Participants reported extreme difficulty accessing shelter beds and food insecurity due to the closure of drop-in programs, food banks, and food distribution programs and noted the deep impacts these changes had on their health and socioeconomic well-being. Disruption in service delivery of shelters and food programs reveal the need for adaptation of strategies to ensure service continuity. Preparedness planning for future public health emergencies can benefit from analysis of lessons learned, as continuity of care was successfully ensured in OAT, SOS and harm reduction service delivery.http://www.sciencedirect.com/science/article/pii/S2667321525000472 |
| spellingShingle | Gillian Kolla Jeanette M. Bowles Katie Upham Hannah Ali Seff Pinch Hafza Majid Laila Bellony Dan Werb Sanjana Mitra The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation SSM: Qualitative Research in Health |
| title | The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation |
| title_full | The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation |
| title_fullStr | The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation |
| title_full_unstemmed | The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation |
| title_short | The impact of the COVID-19 pandemic on access to harm reduction and treatment services among people who inject drugs in Toronto, Canada: A qualitative investigation |
| title_sort | impact of the covid 19 pandemic on access to harm reduction and treatment services among people who inject drugs in toronto canada a qualitative investigation |
| url | http://www.sciencedirect.com/science/article/pii/S2667321525000472 |
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