{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:28:43Z","timestamp":1784834923337,"version":"3.55.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Health Canada: Substance Use and Addiction Program"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["EV1-174804"],"award-info":[{"award-number":["EV1-174804"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Can J Public Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>This paper describes the Safer Opioid Supply (SOS) program, a public health intervention in London, Ontario, in response to the toxic unregulated drug supply which is driving the overdose crisis in Canada.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention<\/jats:title>\n            <jats:p>The London InterCommunity Health Centre (LIHC) SOS program provides comprehensive harm reduction and primary health care services to individuals at risk of overdose from the toxic drug supply. Clients are prescribed high-dose pharmaceutical opioids as replacement for unregulated toxic substances within a low-barrier primary care clinic, with wraparound interdisciplinary social services, embedded in the Ontario Community Health Centre model of care. The program serves people dependent on street-acquired fentanyl who are experiencing medical issues due to their substance use, and who are experiencing challenges accessing other forms of healthcare.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes<\/jats:title>\n            <jats:p>A qualitative analysis of interviews and focus groups conducted in 2022\u20132023 with staff (<jats:italic>n<\/jats:italic>=5) and clients (<jats:italic>n<\/jats:italic>=20) was used to explore impacts of the SOS program. Four outcomes are discussed: safer supply as crucial to engage clients in primary care; safer supply as one component of comprehensive care; the use of a harm reduction approach; and challenges with limited medication options and program capacity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Implications<\/jats:title>\n            <jats:p>Positive health and social outcomes demonstrate the utility of embedding comprehensive substance use services within a primary health care model to address health and social complexity among people who use drugs amid the continuing toxic drug crisis. Responding to an increasingly volatile unregulated supply of drugs, having limited medication options, and providing comprehensive care without long-term funding remain ongoing challenges.<\/jats:p>\n          <\/jats:sec>","DOI":"10.17269\/s41997-025-01006-8","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T11:41:51Z","timestamp":1741779711000},"page":"408-417","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comprehensive substance use services within primary care settings: The Safer Opioid Supply program at London InterCommunity Health Centre"],"prefix":"10.17269","volume":"116","author":[{"given":"Kaitlin","family":"Fajber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sereda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Warren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassidy","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Nash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernie","family":"Pauly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Urbanoski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5743-7153","authenticated-orcid":false,"given":"Gillian","family":"Kolla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"1006_CR1","unstructured":"Atkinson, K. (2023). Parkdale Queen West Community Health Centre Safer Opioid Supply: 2023 Evaluation Report. https:\/\/pqwchc.org\/wp-content\/uploads\/PQWCHC_SOS_EvaluationReport-Final-2023.pdf"},{"issue":"5","key":"1006_CR2","doi-asserted-by":"publisher","first-page":"556","DOI":"10.15288\/jsad.2020.81.556","volume":"81","author":"M Bonn","year":"2020","unstructured":"Bonn, M., Palayew, A., Bartlett, S., Brothers, T. D., Touesnard, N., & Tyndall, M. (2020). Addressing the syndemic of HIV, hepatitis C, overdose, and COVID-19 among people who use drugs: The potential roles for decriminalization and safe supply. Journal of Studies on Alcohol and Drugs, 81(5), 556\u2013560. https:\/\/doi.org\/10.15288\/jsad.2020.81.556","journal-title":"Journal of Studies on Alcohol and Drugs"},{"issue":"1","key":"1006_CR3","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s12939-015-0271-y","volume":"14","author":"Browne, A. J., Varcoe, C., Ford-Gilboe, M., Wathen, C. 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Separate from this study, Kolla received funding from LIHC\u2019s Substance Use and Addictions Program grant to conduct evaluations of the Safer Opioid Supply program. The authors declare that they have no other known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Human Research Ethics Board at the University of Victoria (REB #22-0125).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all participants prior to their participation in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}