Implementation of a low barrier hydromorphone distribution program to prevent fatal overdoses
North America is experiencing an unprecedented opioid overdose epidemic driven by the proliferation of fentanyl and fentanyl-adulterated drugs. Based at the BC Centre on Substance Use (BCCSU) and in collaboration with the BC Centre for Disease Control (BCCDC), I will undertake an ethno-epidemiological study to evaluate the implementation, uptake, and effectiveness of a novel low-barrier hydromorphone distribution program via a secure automated medication dispensing system targeting individuals at high risk of fatal overdose. The study will also examine barriers and facilitators to program scale up. The BCCDC is responsible for the implementation and operation of the distribution systems and program, with the BCCSU conducting the external evaluation. Data collection will involve qualitative interviews with 60 program participants and 15 stakeholders, as well as ethnographic fieldwork. The Vancouver Area Network of Drug Users (VANDU) mandate is to improve the lives of people who use drugs (PWUD), and they benefit by playing a key role in an evaluation and knowledge translation for a program with the potential to directly benefit PWUD. VANDU members will be included on a community advisory committee, be employed as peer research assistants, and be involved in future policy development and knowledge translation.