Background:
Canada’s drug toxicity crisis has disproportionately impacted equity-deserving populations, particularly Black, Indigenous, and Racialized individuals, who face systemic barriers to accessing traditional healthcare and harm reduction services. In response, Hamilton Urban Core Community Health Centre (HUCCHC) launched the Prescribed Alternatives and Outreach (PAO) program in 2023.
Description of program:
The PAO program is a community-based model of care for individuals with chronic opioid use at high risk of overdose due to the toxic street drug supply. The program provides prescriptions for safer supply medications as a regulated alternative, alongside integrated services such as primary care, counselling, housing support, identification assistance, clinical services, nutritional support, chiropody, dental care, and the Consumption and Treatment Service (CTS). A unique aspect of the PAO program is its focus on equity-deserving populations. To address access disparities, HUCCHC integrated a Community Cultural Ambassador role, to support outreach and capacity building to ensure services meet the needs of Black, Indigenous, and Racialized communities.
Effectiveness:
A multi-methods evaluation was conducted, including 18 client interviews and 8 staff interviews between June and December 2024. Clients reported reduced overdoses, withdrawal symptoms, and fentanyl use, alongside improved health, housing stability, financial security, and access to essential healthcare and harm reduction services. Black and Indigenous participants highlighted enhanced trust and engagement due to culturally responsive services. Clients highlighted that the program created a trusting, stigma-free environment where equity-deserving populations felt valued, respected, and supported. Challenges included high staff turnover, relocation-related access barriers and end of pilot funding for the program, which threatening program sustainability and continuity of care.
Conclusion and next steps:
The PAO program demonstrates the effectiveness of safer supply within a culturally responsive, community-based model. Findings emphasize the need for long-term funding, expanded peer-led services, and continuity of programs for equity-deserving populations. |