Appreciation of the role and experience of experiencial experts related to overdoses in Montérégie

Background
For several years, Monteregie has been grappling with an opioid overdose crisis investigated by the public health direction (PHD). Between February 2018 and November 2022, we noticed an increase in overdose signals in Monteregie (350) in addition to a significant increase in the number of deaths (273) from suspected drug poisoning.

Since the 2010s, the user-partner, who is involved in their care and in improving health care and social services, can also get involved as experiencial experts (EE). The PHD of Monteregie has set up two EE committees linked to the opioid crisis (sex workers and users of psychoactive substances) to directly collect the opinions of users of psychoactive substances (excluding the use alone of cannabis, alcohol and tobacco) in order to improve harm reduction means and adapt them to the reality of consumers. These groups are led by a professional from the public health department (group animator or GA). With this in mind, the opinion of the EE members of the committees was collected in order to evaluate its operation and its impact.

Methods
A qualitative phenomenological design, based on the conceptual framework “citizen experience in the service of prevention”, was used with semi-directed interviews with focus groups in Longueuil and Ste-Hyacinthe in May 2023. A thematic analysis was subsequently carried out in order to analyze the results.

Results
The EEs appreciate the flexibility, the support offered and the concrete questions from the GA. The EEs feel that their role is valued and recognized. They also enjoy off-committee activities. As for the functioning of the committees, the atmosphere is pleasant and respectful. The fact that the rules governing meetings are flexible is also appreciated. As for resources, the duration of the meetings (1h30) is adequate as is the schedule of the sessions. As for the impact, the EEs put their learning into practice in the community when necessary and have begun to reflect on their own consumption. EEs mentioned wanting to avoid volunteering, as remuneration is important to them. In addition, the level of language used is adequate during committee meetings, but should be reviewed during certain off-committee activities.

Conclusion
The qualitative evaluation of the committees shows that they are appreciated by the members. In order to improve the EE committees, it would be relevant, among other things, to organize a short meeting concerning the level of language to adopt with the EE groups before non-committee activities and to allocate a budget intended for the remuneration of the activities that are currently voluntary. In short, the results and outcomes of this project suggest that the citizen approach through EEs can mutually benefit EEs and public health, particularly in the opioid overdose crisis.