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Background <p>It has been just over a decade since communities in Canada recognized the impact of the opioid crisis. In 2019, funding expanded supervised consumption sites in Ontario. Attention has focused on injection drug use, with harm reduction programs providing free equipment to prevent the transmission of blood-borne infections. In the changing landscape of substance use, more individuals are now smoking opioids and stimulants, and programs have been slow to adapt. By 2023, three out of four substance-related deaths in Ottawa, Ontario's second-largest city, showed evidence of inhalation. Compounding the complexity of the increasingly toxic and unregulated drug supply, Ottawa has been experiencing a housing crisis. One in six opioid-related deaths in Ontario involved people experiencing homelessness. Sandy Hill Community Health Center and Belong Ottawa Drop-in Centre partnered to explore the healthcare-related needs, barriers and priorities of people experiencing homelessness who inhale stimulants and/or opioids.</p> Methods <p>A qualitative study using an ethnographic approach was conducted in the summer of 2024 in Ottawa to identify the health needs for individuals who are unhoused and using opioids and/or stimulants in urban Ottawa, as well as their barriers to care. Individuals who inhale substances, as well as community agency staff, were interviewed. Interview data were analyzed using thematic analysis, and survey data were analyzed using descriptive statistics. Findings were presented back to the community with the help of the community advisory group.</p> Results <p>Thirty interviews were conducted with service users who identified as homeless and inhaled opioids and/or stimulants, and 10 interviews were with service providers. Interviews ranged in length from 20–60&#xa0;min and were transcribed. The majority of service users were not homeless before using drugs and approximately one third reported they did not trust health care providers. Themes were organized using an ecological model and included Early Trauma and Lost Connections, Systemic Rigidity, Erasure from Public Space, and Misplaced Blame and the Absence of Home.</p> Conclusions <p>The study findings are relevant for communities working with people who inhale stimulants and/or opioids, health care providers, and for moving towards greater systems-level organizational change.</p>

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Addressing the needs of people who inhale opioids and/or stimulants

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月29日

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  • Joanna Binch,
  • Sheila Jewell,
  • Emily MacKay,
  • Vihara Jayasinghe-Mudalige

摘要

Background

It has been just over a decade since communities in Canada recognized the impact of the opioid crisis. In 2019, funding expanded supervised consumption sites in Ontario. Attention has focused on injection drug use, with harm reduction programs providing free equipment to prevent the transmission of blood-borne infections. In the changing landscape of substance use, more individuals are now smoking opioids and stimulants, and programs have been slow to adapt. By 2023, three out of four substance-related deaths in Ottawa, Ontario's second-largest city, showed evidence of inhalation. Compounding the complexity of the increasingly toxic and unregulated drug supply, Ottawa has been experiencing a housing crisis. One in six opioid-related deaths in Ontario involved people experiencing homelessness. Sandy Hill Community Health Center and Belong Ottawa Drop-in Centre partnered to explore the healthcare-related needs, barriers and priorities of people experiencing homelessness who inhale stimulants and/or opioids.

Methods

A qualitative study using an ethnographic approach was conducted in the summer of 2024 in Ottawa to identify the health needs for individuals who are unhoused and using opioids and/or stimulants in urban Ottawa, as well as their barriers to care. Individuals who inhale substances, as well as community agency staff, were interviewed. Interview data were analyzed using thematic analysis, and survey data were analyzed using descriptive statistics. Findings were presented back to the community with the help of the community advisory group.

Results

Thirty interviews were conducted with service users who identified as homeless and inhaled opioids and/or stimulants, and 10 interviews were with service providers. Interviews ranged in length from 20–60 min and were transcribed. The majority of service users were not homeless before using drugs and approximately one third reported they did not trust health care providers. Themes were organized using an ecological model and included Early Trauma and Lost Connections, Systemic Rigidity, Erasure from Public Space, and Misplaced Blame and the Absence of Home.

Conclusions

The study findings are relevant for communities working with people who inhale stimulants and/or opioids, health care providers, and for moving towards greater systems-level organizational change.