The Ontario Integrated Supervised Injection Services Cohort Study of People Who Inject Drugs in Toronto, Canada (OiSIS-Toronto): Cohort Profile

Ayden I Scheim,Ruby Sniderman,Sean B Rourke,Dan Werb,Stefan D Baral,Zoë R Greenwald,Zachary Bouck,Gary Garber,Kednapa Thavorn,Elizabeth Mclean,Geoff Bardwell,Ri Wang,Kate Mason,Sanjana Mitra

doi:10.1007/s11524-021-00547-w

Abstract

The Ontario Integrated Supervised Injection Services cohort in Toronto, Canada (OiSIS-Toronto) is an open prospective cohort of people who inject drugs (PWID). OiSIS-Toronto was established to evaluate the impacts of supervised consumption services (SCS) integrated within three community health agencies on health status and service use. The cohort includes PWID who do and do not use SCS, recruited via self-referral, snowball sampling, and community/street outreach. From 5 November 2018 to 19 March 2020, we enrolled 701 eligible PWID aged 18+ who lived in Toronto. Participants complete interviewer-administered questionnaires at baseline and semi-annually thereafter and are asked to consent to linkages with provincial healthcare administrative databases (90.2% consented; of whom 82.4% were successfully linked) and SCS client databases. At baseline, 86.5% of participants (64.0% cisgender men, median ([IQR] age= 39 [33–49]) had used SCS in the previous 6 months, of whom most (69.7%) used SCS for <75% of their injections. A majority (56.8%) injected daily, and approximately half (48.0%) reported fentanyl as their most frequently injected drug. As of 23 April 2021, 291 (41.5%) participants had returned for follow-up. Administrative and self-report data are being used to (1) evaluate the impact of integrated SCS on healthcare use, uptake of community health agency services, and health outcomes; (2) identify barriers and facilitators to SCS use; and (3) identify potential enhancements to SCS delivery. Nested sub-studies include evaluation of “safer opioid supply” programs and impacts of COVID-19.

Highlights

It is estimated that 2016, 0.70% of Canadians aged 15 to 64 years used injection drugs, up from 0.55% in 2011 [1]
Baseline data collection began on 5 November 2018; as the cohort is open, we report on participants enrolled by 19 March 2020, prior to the temporary suspension of new enrolments due to COVID-19 restrictions in Toronto
While all staff eventually went through those institutional processes, we provided them with close support, including financial assistance to obtain identification needed for the background checks

Summary

Introduction

It is estimated that 2016, 0.70% of Canadians aged 15 to 64 years used injection drugs, up from 0.55% in 2011 [1]. In the context of unregulated drug markets and unsafe. Mitra British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, Canada. S. Mitra Interdisciplinary Studies Graduate Program, University of British Columbia, 2357 Main Mall, Vancouver, BC 270, V6T 1Z4, Canada. K. Thavorn Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada

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Results

Discussion

Conclusion