Exploring the shifting landscape of medication-based drug treatment and safer supply in the fentanyl era: a research program to address the evolving overdose crisis in BC

Canada continues to grapple with an overdose crisis driven by illicitly manufactured fentanyl and novel psychoactive substances (e.g., etizolam, xylazine). The drug treatment landscape is rapidly evolving in response, and includes the implementation and expansion of a number of medication-based drug treatments (e.g., oral and injectable hydromorphone) and prescribed safer supply programs (SSP) that provide pharmaceutical alternatives to the toxic drug supply. However, socio-structural factors have impeded broader expansion and support, and SSP remain controversial with many healthcare providers expressing concern. This ethno-epidemiological research program will gather the views of people who use drugs, policymakers, and health system actors across BC to explore how individual, social, structural and environmental factors shape access to and outcomes from existing and emerging medication-based drug treatment programs and SSP. This is a critical opportunity examine the rapidly shifting drug treatment and overdose response landscape to better inform public health approaches to the ongoing overdose crisis. Knowledge gained will inform and guide future policy and public health developments to improve the lives of people who use drugs.