{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T09:07:54Z","timestamp":1779440874549,"version":"3.53.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The increasingly unpredictable and toxic unregulated drug supply puts people who use drugs at high risk of overdose and death. In April 2022, Insite\u2014North America's first sanctioned supervised consumption site\u2014started a prescribed powdered fentanyl safer supply program available to patients for on\u2010site consumption. This novel pharmaceutical product, created in partnership with a community compounding pharmacy, can be smoked or injected; is free of dangerous contaminants (e.g., xylazine and non\u2010prescribed benzodiazepines); and has a predictable concentration. This case describes a man in his 50s with no fixed address and severe opioid use disorder and stimulant use disorder prescribed powdered fentanyl at Insite, which led to reduced use of unregulated drugs, increased supervised consumption site engagement and increased retention on oral opioid agonist therapy. Expansion of supervised consumption services to incorporate the provision of prescribed alternatives to the drug supply for on\u2010site supervised consumption holds promise and should be evaluated.<\/jats:p>","DOI":"10.1111\/dar.70175","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:59:47Z","timestamp":1778745587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safe Supply at Insite, North America's First Supervised Consumption Site: A Case Report of Reduced Harms From the Toxic Drug Supply in a Client Prescribed Powdered Fentanyl Alternative"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4195-3284","authenticated-orcid":false,"given":"Nadia","family":"Fairbairn","sequence":"first","affiliation":[{"name":"Department of Medicine The University of British Columbia  Vancouver Canada"},{"name":"Vancouver Coastal Health Authority  Vancouver Canada"},{"name":"British Columbia Centre on Substance Use  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lysyshyn","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Authority  Vancouver Canada"},{"name":"School of Population and Public Health University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupinder","family":"Brar","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Authority  Vancouver Canada"},{"name":"School of Population and Public Health University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Holliday","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Authority  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2005.08.004"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107517\u20101\u20109"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.04.017"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.012"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2024.104339"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjment\u20102025\u2010301629"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2025.105070"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.17269\/s41997\u2010025\u201001006\u20108"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.17269\/s41997\u2010024\u201000979\u20102"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103742"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104157"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102769"},{"key":"e_1_2_11_14_1","unstructured":"Office of the Provincial Health Officer \u201cA Review of Prescribed Safer Supply Programs Across British Columbia: Recommendations for Future Action \u201d2023 https:\/\/www2.gov.bc.ca\/assets\/gov\/health\/about\u2010bc\u2010s\u2010health\u2010care\u2010system\/office\u2010of\u2010the\u2010provincial\u2010health\u2010officer\/reports\u2010publications\/special\u2010reports\/a\u2010review\u2010of\u2010prescribed\u2010safer\u2010supply\u2010programs\u2010across\u2010bc.pdf."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2010.12.002"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.211515"},{"key":"e_1_2_11_17_1","volume-title":"A Guideline for the Clinical Management of Opioid Use Disorder","author":"British Columbia Centre on Substance Use","year":"2023"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","unstructured":"M.Godvin J. 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A.Molina et\u00a0al. \u201cEstimating the Daily Milligrams of Morphine Equivalent of Illicit Fentanyl Use in Los Angeles: Clinical and Epidemiological Implications \u201dpreprint medRxiv May 5 2026 https:\/\/doi.org\/10.1101\/2025.10.07.253375.","DOI":"10.1101\/2025.10.07.25337514"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954\u2010023\u201000867\u2010x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2026.105200"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2025.100338"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2025.104905"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010076336"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469\u2010023\u201001219\u20103"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.220892"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(25)00070\u20102"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2025.105124"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-025-01298-6"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2024.104600"},{"key":"e_1_2_11_30_1","volume-title":"Supervised Consumption Services in Toronto: Evidence and Recommenbdations","author":"Centre on Drug Policy Evaluation","year":"2024"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70175","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70175","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T08:47:09Z","timestamp":1779439629000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/dar.70175"],"URL":"https:\/\/doi.org\/10.1111\/dar.70175","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70175"}}