Implementation of risk mitigation prescribing during dual public health emergencies: A qualitative study among Indigenous people who use drugs and health planners in Northern British Columbia, Canada

Simple item page
dc.contributor.authorBarker, Brittany
dc.contributor.authorNorton, Alexa
dc.contributor.authorWood, Shawn
dc.contributor.authorMacevicius, Celeste
dc.contributor.authorHogan, Katherine
dc.contributor.authorCadieux, Katt
dc.contributor.authorMeilleur, Louise
dc.contributor.authorNosyk, Bohdan
dc.contributor.authorUrbanoski, Karen
dc.contributor.authorPauly, Bernie
dc.contributor.authorWieman, Nel
dc.date.accessioned2025-03-18T16:02:05Z
dc.date.available2025-03-18T16:02:05Z
dc.date.issued2024
dc.description.abstractBackground In response to the dual public health emergencies of COVID-19 and the overdose crisis, the Government of British Columbia (BC) introduced risk mitigation prescribing, or prescribed safer supply. In the context of colonialism and racism, Indigenous people are disproportionately impacted by substance use harms and experience significant barriers to receiving care, particularly those living in rural and remote communities. As part of a larger provincial evaluation, we sought to assess the implementation of risk mitigation prescribing as experienced by Indigenous people who use drugs (IPWUD) in Northern BC. Methods We used the Consolidated Framework for Implementation Research and the First Nations Perspective on Health and Wellness as conceptual frameworks to guide the study. In partnership with people with lived/living experience, we conducted 20 qualitative interviews with IPWUD. Data were supplemented by four interviews with health planners and analyzed thematically. Results Participants reported limited implementation of risk mitigation prescribing in Northern BC, with unique regional challenges and innovative facilitators to access. Analysis of supplementary health planner data was consistent with the experiences of IPWUD and together provided a comprehensive picture of implementation in Northern BC. Four themes emerged: 1) Northern socio-politico-cultural barriers to implementation (outer setting), 2) rural and remote healthcare delivery challenges (inner setting), 3) adaptability of risk mitigation prescribing on Northern wellness (intervention characteristics), and 4) Northern ingenuity, relationality and champions facilitating access (implementation process). Conclusions Implementation and access to risk mitigation prescribing in Northern BC was limited, with region-specific applicability challenges and a health service delivery model that was not able to sufficiently meet the unique service needs of IPWUD. Demonstrating Northern ingenuity, peer groups, harm reduction community champions, and telehealth services were identified as stopgap measures that promoted access and reduced inequitable implementation within the region.
dc.description.sponsorshipThis study was funded by the Canadian Institutes of Health Research (CIHR) grant # 172671 and Michael Smith Health Research BC #18951. AN is supported by a CIHR Doctoral Award and University of British Columbia Four-Year Doctoral Fellowship. KU is funded by the Canada Research Chairs Program (#CRC-2019-00212). Funders had no role in the study design, data collection, analysis, or interpretation of the data, writing of the article or submission for publication.
dc.identifier.citationBarker, B., Norton, A., Wood, S., Macevicius, C., Hogan, K., Cadieux, K., Meilleur, L., Nosyk, B., Urbanoski, K., Pauly, B., & Wieman, N. (2024). Implementation of risk mitigation prescribing during dual public health emergencies: A qualitative study among Indigenous people who use drugs and health planners in Northern British Columbia, Canada. International Journal of Drug Policy, 136, 104679. https://doi.org/10.1016/j.drugpo.2024.104679
dc.identifier.urihttps://doi.org/10.1016/j.drugpo.2024.104679
dc.identifier.urihttps://hdl.handle.net/1828/21670
dc.language.isoen
dc.publisherInternational Journal of Drug Policy
dc.rightsCC BY-NC 4.0
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectcommunity-based participatory research
dc.subjectIndigenous peoples
dc.subjectoverdose
dc.subjectprescribed safer supply
dc.subjectpublic health emergency
dc.subjectrisk mitigation measures
dc.titleImplementation of risk mitigation prescribing during dual public health emergencies: A qualitative study among Indigenous people who use drugs and health planners in Northern British Columbia, Canada
dc.typeArticle

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
barker_brittany_IntJDrugPol_2025.pdf
Size:
5.1 MB
Format:
Adobe Portable Document Format
Download

Collections

Faculty Publications (Human & Social Development)
 
University of Victoria Libraries

We acknowledge and respect the Lək̓ʷəŋən (Songhees and Esquimalt) Peoples on whose territory the university stands, and the Lək̓ʷəŋən and W̱SÁNEĆ Peoples whose historical relationships with the land continue to this day.