JMIR Publications

ABSTRACT

Background:

The opioid overdose crisis currently affecting Canada has led to several thousand deaths. The COVID-19 pandemic has exacerbated the consequences of this crisis, particularly with the instability of the unregulated drug market. Québec is observing a similar trend: the opioids consumed are more dangerous, and the number of overdoses is rising. Opioid use disorder (OUD) therefore represents a major public health issue. Offering appropriate interventions such as opioid agonist therapy integrated into primary care is one way of reducing the risk of death from overdose.

Objective:

The aim of this research is to evaluate the implementation of an outreach clinic offering a low-threshold treatment program for opioid use disorders in Québec. The secondary objective is to identify the factors that foster the participation of socially excluded people living or having lived with OUD in primary care research.

Methods:

This study is being conducted in the Montérégie region and comprises three phases: exploratory, photovoice and participatory evaluation. The qualitative research adopts a participatory approach by involving socially excluded people targeted by the clinic services (e.g. people experiencing homelessness and living with OUD). A committee of peer researchers, made up of experts in living with OUD, will be set up and will hold 10 meetings at various stages of the research. Two participant profiles will be involved: (1) healthcare professionals and community workers who will take part in semi-structured interviews and (2) people living with or having lived with OUD, who will take part in the photovoice or peer researcher committee meetings.

Results:

The peer research committee was formed in Winter 2024, and by November 2024, five meetings had been held. As of November 2024, four photovoice sessions had been conducted and 14 healthcare professionals and community workers had participated in the semi-structured interviews. Preliminary results from different phases of this project were presented at the 2023 and 2024 North American Primary Care Research Group (NAPCRG) Conferences, as well as at the 2024 International Society for the Study of Drug Policy (ISSDP) Conference.

Conclusions:

The anticipated outcome is the establishment of an outreach clinic for opioid use disorders outside a major urban centre, with a range of services tailored to the needs of socially excluded people living with OUD. The co-construction of this clinic in collaboration with people living with or having lived with OUD will make it possible to respond adequately to their overall health needs and reduce the barriers to access that they may face in conventional care structures.