Access to tablet injectable opioid agonist therapy in rural and smaller urban settings in British Columbia, Canada: a qualitative study

Original research
by
Bardwell, Geoff et al

Release Date

2023

Geography

Canada

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

We conducted this study to understand the rural context and factors that affected access of TiOAT programs.

Findings/Key points

TiOAT access varied considerably. TiOAT delivery in rural settings is complicated due to geographic challenges. Participants who were homeless and staying at a nearby shelter or those in centrally-located supportive housing had minimal issues compared to those living in more affordable housing on the outskirts of town with limited transportation options. Dispensing policies that required daily-witnessed ingestion multiple times daily were challenging for most. Only one site provided evening take-home doses whereas participants at the other site could only resort to the illicit opioid supply to address withdrawal outside of program hours. Participants described the clinics as providing a positive and familial social environment compared to experiences of stigma elsewhere. Medication interruptions did occur when participants were in hospital and custodial settings, leading to withdrawal, program discontinuation, and overdose risk.

Design/methods

Semi-structured interviews (n=32)

Keywords

Rural/remote
Injecting drugs
Small/medium cities
Substitution/OAT
Barriers and enablers