- Opioid Use Disorder Treatment
- HIV, Drug Use, Sexual Risk
- Substance Abuse Treatment and Outcomes
- Forensic Toxicology and Drug Analysis
- Pharmaceutical Practices and Patient Outcomes
- Cannabis and Cannabinoid Research
- Pain Management and Opioid Use
- Health Policy Implementation Science
- Prenatal Substance Exposure Effects
- Mental Health Treatment and Access
- Mental Health and Patient Involvement
- Occupational Health and Safety Research
- Alcohol Consumption and Health Effects
- Migration, Health and Trauma
- Ethics in Clinical Research
- Veterinary Pharmacology and Anesthesia
- Pediatric Pain Management Techniques
- Homelessness and Social Issues
- HIV/AIDS Research and Interventions
- Medication Adherence and Compliance
- Supply Chain Resilience and Risk Management
- Psychedelics and Drug Studies
- Poisoning and overdose treatments
- Infectious Encephalopathies and Encephalitis
- Public Health Policies and Education
University of British Columbia
2023-2024
British Columbia Centre on Substance Use
2023-2024
St. Paul's Hospital
2023-2024
St. Paul's Hospital
2024
St. Michael's Hospital
2020-2023
St Michael’s Hospital
2023
Unity Health Toronto
2021-2022
Centre for Drug Research and Development
2022
University of California, San Diego
2018-2021
University of California System
2020
Background Opioid overdose deaths have increased exponentially in the United States. Bystander response to opioid ideally involves administering naloxone, providing rescue breathing, and calling 911 summon emergency medical assistance. Recently US, public health safety agencies begun seeking use calls as a method identify deliver post-overdose interventions patients. Little is known about opinions of PWUDs barriers, benefits, or potential harms linked system. We sought understand...
Abstract Background The North American opioid overdose crisis is driven in large part by the presence of unknown psychoactive adulterants dynamic, unregulated drug supply. We herein report first detection veterinary compound xylazine Toronto, largest urban center Canada, city’s checking service. Methods Toronto’s Drug Checking Service launched October 2019. Between then and February 2021, 2263 samples were submitted for analysis. service offered voluntarily at harm reduction agencies that...
Xylazine is an animal tranquilizer increasingly detected in those who have died of opioid overdose Philadelphia, PA and elsewhere. Despite increasing presence xylazine the local fentanyl/heroin drug market its association with ulcers, there are few perspectives about from people use drugs no data utility a hypothetical test strip.Between January to May 2021 PA, used had previously fentanyl strips were queried strips. Interviews transcribed analysis was conducted via conventional content...
Canada is experiencing an unprecedented drug toxicity crisis driven by a highly toxic unregulated supply contaminated with fentanyl, benzodiazepine, and other drugs. Safer pilot programs provide prescribed doses of pharmaceutical alternatives to individuals accessing the have been implemented prevent overdose reduce related harms. Given recent emergence these paucity data on implementation challenges, we sought document challenges in their initial phase.We obtained organizational progress...
Abstract Background Rural and smaller urban settings in Canada are disproportionately impacted by the overdose crisis, highlighting need for novel public health interventions within these jurisdictions. Tablet injectable opioid agonist therapy (TiOAT) programs have been implemented select rural communities as a means to address drug-related harms. However, little is known about accessibility of programs. Therefore, we conducted this study understand context factors that affected access TiOAT...
Despite increased availability of take-home naloxone, many people who use opioids do so in unprotected contexts, with no other person might administer naloxone present, increasing the likelihood that an overdose will result death. Thus, there is a social nature to being "protected" from mortality, which highlights importance identifying background factors promote access protective networks among opioids.
In Canada, the ongoing fatal overdose crisis remains driven by unpredictable potency and content of illicit drug supply. From August 2022 until October 2023, Drug User Liberation Front [DULF] operated a compassion club [CC], which sells drugs known composition purity without medical oversight. The present study is qualitative evaluation this project. December to February we interviewed 16 CC members about their experiences with DULF's CC. Using semi-structured interview guide, participants...
Fatal opioid overdoses can be prevented by overdose prevention programs (OOPPs). The present study qualitatively examined the diffusion process of an OOPP among 30 persons who inject drugs (PWIDs) in opioid-saturated community. Purposive sampling was used to recruit participants into three groups based on familiarity with OOPP. Findings revealed that often adopted OOPP, which offered a local harm reduction organization, if first exposed staff hosting and implementing it. Barriers adoption...
Background: People with opioid use disorder (OUD) have high rates of hospital admissions and patient-directed discharge, leading to significant morbidity mortality. In this study, we aimed understand hospitalist attitudes toward patients OUD leaving before treatment completion their willingness collaborate in future initiatives focused on improving the experience hospital-based care for OUD. Methods: We conducted semi-structured interviews hospitalists at two hospitals Philadelphia, PA...
Despite rural regions being disproportionately impacted by the toxic drug supply, little is known about contextual factors influencing access to opioid agonist treatment (OAT) specific residents. The present study examines these in a and coastal setting British Columbia, Canada.
Objectives. To identify factors that influence when people who use drugs (PWUDs) call 911 for an overdose. Methods. We conducted 45 qualitative interviews and 180 surveys with PWUDs had recently witnessed overdoses in Southern California from 2017 to 2019. used conditional inference tree random forest models generate validate a model predict whether would be called. Results. Our good in- (83%) out-of-sample (84%) predictive accuracy. Three aspects of the social policy environment influenced...
Stigma overwhelmingly affects people who inject drugs. The COVID-19 pandemic posed unique challenges for drugs, are already stigmatized as being "dangerous and spreading disease." present study explored ways in which stigma was experienced by a sample of drugs Toronto, Canada following COVID-related public health precaution measures.Qualitative interviews were conducted with (n = 24) recruited from supervised consumption sites Canada. semi-structured interview guide focused on the impact...
The evolving and unpredictable unregulated drug market has driven an unprecedented overdose crisis that requires effective intervention. Growing evidence suggests novel opioid agonist treatments, such as tablet injectable therapy (TiOAT), have potential to prevent overdoses other drug-related harms. More is needed characterize their utility in achieving these outcomes. current article analysis of two TiOAT programs implemented British Columbia, Canada, assess impact on health well-being,...
Toronto's Drug Checking Service (DCS) provides people who use drugs with information on the chemical composition of their substances and conducts real-time monitoring unregulated drug supply. Presented are first known data three newly detected synthetic cannabinoids (SCs) in Toronto, Ontario.The present from samples analyzed between April November 2020. Samples were collected at partnering harm reduction agencies Toronto using gas or liquid chromatography-mass spectrometry. An intake survey...
Abstract Background Public health research frequently relies on collaborations with community-based organizations, and these partnerships can be essential to the success of a project. However, while public ethics oversight policies have historically focused ensuring that individual subjects are protected from unethical or unfair practices, there few guidelines protect organizations which facilitate relationships – composed same vulnerable populations. As universities, governments, donors...