Background: After the onset of the COVID-19 pandemic, an increased number of people were killed by the toxic drug supply in Canada. Emerging evidence suggests that reduced access to harm reduction services was a contributing factor.
Objective: To explore the impacts of the pandemic-related regulations on supervised consumption site (SCS) service delivery in Vancouver and Surrey, Canada.
Methods: Between October 2021 and March 2022, in-depth, semi-structured interviews were conducted with staff from two SCS: SafePoint in Surrey (n=12) and Insite in Vancouver (n=9). Thematic analysis focused on key changes to SCS delivery after the emergence of the COVID-19 pandemic, with a focus on associated challenges and emergent staff responses.
Results: Participants described key challenges as: capacity restrictions hindering service access and quality of care; exclusion of frontline perspectives from evolving SCS policy and practice decision-making; intensified hierarchies between staff and service users; and issues related to overdose presentations, response policies and procedures. Emergent staff responses to these challenges included: collective staff resistance to policy changes; individual frontline staff non-compliance with emerging policies and procedures; and staff disengagement from their roles at SCS.
Implications: This study highlights how COVID-19-related changes to service delivery produced challenges for SCS staff and service users, while identifying strategies employed by staff to address these challenges. Additionally, the findings point to opportunities to improve care and supports for people who use drugs in the context of intersecting public health crises.