{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:47:14Z","timestamp":1787510834945,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000085","name":"Ontario HIV Treatment Network","doi-asserted-by":"publisher","award":["Breaking New Ground Grant (EFP\u20101113)"],"award-info":[{"award-number":["Breaking New Ground Grant (EFP\u20101113)"]}],"id":[{"id":"10.13039\/501100000085","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The ongoing opioid overdose crisis, which has killed over 30,000 people in Canada since 2016, is driven by the volatility of an unregulated opioid drug supply comprised primarily of fentanyl. The Canadian government has recently funded safer opioid supply (SOS) programs, which include off\u2010label prescriptions of pharmaceutical\u2010grade opioids to high risk individuals with the goal of reducing overdose deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2021, we examined the implementation and adaption of four SOS programs in Ontario. These programs use a primary care model and serve communities experiencing marginalisation. We conducted semi\u2010structured interviews with program clients. We present the results of a thematic analysis with the aim of describing clients' self\u2010reported impact of these programs on their health and well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We interviewed 52 clients between June and October 2021 (mean age 47\u2009years, 56% men, 17% self\u2010identified Indigenous, 14% living with HIV). Our results indicate multifaceted pathways to improved self\u2010reported health and well\u2010being among clients including changes to drug use practices, fewer overdoses, reduced criminalised activity, improved trust and engagement in health care, and increased social stability (e.g., housing).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion<\/jats:title>\n                    <jats:p>Most clients reported that the intervention saved their life because of the reduced frequency of overdoses. Findings suggest that SOS programs improved clients' health outcomes and increase opportunities for engagement in health services. Our results provide insight into the mechanisms behind some of the emergent evidence on the impact of safer supply prescribing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.13745","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T03:15:47Z","timestamp":1695006947000},"page":"1825-1837","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["\u2018I don't chase drugs as much anymore, and I'm not dead\u2019: Client reported outcomes associated with safer opioid supply programs in Ontario, Canada"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0307-8482","authenticated-orcid":false,"given":"Rose A.","family":"Schmidt","sequence":"first","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"},{"name":"Institute for Mental Health Policy Research Centre for Addiction and Mental Health  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nat","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Kryszajtys","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Rudzinski","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"},{"name":"School of Social Work University of Windsor  Windsor Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Perri","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-2016","authenticated-orcid":false,"given":"Adrian","family":"Guta","sequence":"additional","affiliation":[{"name":"School of Social Work University of Windsor  Windsor Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita C.","family":"Benoit","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"},{"name":"Department of Health and Society University of Toronto Scarborough  Scarborough Canada"},{"name":"Women's College Research Institute Women's College Hospital  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Bayoumi","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions Li Ka Shing Knowledge Institute, St. Michael's Hospital  Toronto Canada"},{"name":"Department of Medicine University of Toronto  Toronto Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Canada"},{"name":"Division of General Internal Medicine St. Michael's Hospital  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel","family":"Challacombe","sequence":"additional","affiliation":[{"name":"Canadian AIDS Treatment Information Exchange  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Hales","sequence":"additional","affiliation":[{"name":"Regent Park Community Health Centre  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Kenny","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Manitoba  Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Kolla","sequence":"additional","affiliation":[{"name":"Canadian Institute for Substance Use Research University of Victoria  Victoria Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmet","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"South Riverdale Community Health Centre  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sereda","sequence":"additional","affiliation":[{"name":"London InterCommunity Health Centre  London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanky","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine University of Toronto  Toronto Canada"},{"name":"Parkdale Queen West Community Health Centre  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-3681","authenticated-orcid":false,"given":"Carol","family":"Strike","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Changing circumstances surrounding opioid\u2010related deaths in Ontario during the COVID\u201019 pandemic","author":"Gomes T","year":"2021"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2017.10.016"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-022-03908-x"},{"key":"e_1_2_11_5_1","volume-title":"Opioid\u2010 and stimulant\u2010related harms in Canada","author":"Special Advisory Committee on the Epidemic of Opioid 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Montreal: Le lnstitut universitaire sur les d\u00e9pendances (IUD).2022."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14947"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000156"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2021.103364"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232086"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.01.027"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/amajethics.2020.723"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.17269\/s41997-020-00315-4"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.220892"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.03.012"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.0109"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810635"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201618"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-020-00489-9"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103742"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103601"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048353"},{"key":"e_1_2_11_30_1","volume-title":"Access to prescribed safer supply in British Columbia: policy direction","author":"Ministry of Mental Health and Addictions, Ministry of Health","year":"2021"},{"key":"e_1_2_11_31_1","volume-title":"Government of Canada approves new treatment options for opioid use disorder and supports research, treatment and harm reduction projects in Ontario [press release]","year":"2019"},{"key":"e_1_2_11_32_1","volume-title":"Safer opioid supply program: preliminary report","author":"Kolla G","year":"2021"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2021.306692"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108202"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109440"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00614-8"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305612"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258"},{"key":"e_1_2_11_39_1","volume-title":"Risks and harms associated with the nonmedical use of benzodiazepines in the unregulated drug supply in Canada","author":"Canadian Centre on Substance Use and Addiction","year":"2021"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13214"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0000000000000070"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103709"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.13745","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T03:28:27Z","timestamp":1699586907000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.13745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,18]]},"references-count":41,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/dar.13745"],"URL":"https:\/\/doi.org\/10.1111\/dar.13745","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,18]]},"assertion":[{"value":"2023-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}