Participant perspectives on a safe supply program in Vancouver, Canada: impacts, satisfaction and improvement...

The ongoing toxic drug crisis in Canada, driven largely by fentanyl proliferation, has led to ever-escalating overdose rates. The Safer Alternatives for Emergency Response (SAFER) program was launched in Vancouver, British Columbia (BC) in 2021 to reduce overdose risk by offering prescribed pharmaceutical alternatives, including fentanyl medications. This study aimed to evaluate satisfaction and the program's perceived impact on health and social outcomes among SAFER participants.

Data were collected from 78 SAFER participants through baseline interviewer-administered questionnaires. The primary outcome was self-reported changes in drug use, health status and social outcomes. Descriptive statistics summarized participant characteristics and outcomes.

Among 78 participants, with 22 (28%) identifying as women or gender diverse, 76% reported reduced drug use, while 71% experienced reductions in drug cravings/withdrawal and overdose risk, respectively. Safer drug-use behaviours were also reported: 56% reported that they were more likely to use sterile equipment, 37% said they were more likely to check their drugs, and 35% said they were more likely to carry naloxone. Improvements in overall physical health (58%), mental health (63%), financial stability (55%), and social connections (49%) were also noted. High satisfaction with services was reported (78%), although 71% suggested improvements, including extended hours, easier access to carry doses, and expanded medication options.

These findings indicate that the SAFER program is perceived as effective in reducing overdose risk and improving health and social outcomes. However, barriers such as service accessibility and limited medication options remain. Addressing these concerns could enhance program outcomes. Further large-scale research is recommended to confirm these results and explore long-term impacts.