FHS professor awarded grant to evaluate expanded prescription guidelines for opioid agonist therapy and pandemic prescribing

By Geron Malbas

Faculty of Health Sciences assistant professor Kanna Hayashi recently received the CIHR Operating Grant COVID-19 Mental Health and Substance Use Service Needs and Delivery to fund her research, titled “Evaluation of innovative risk mitigation services in the context of dual crises of COVID-19 and overdose among people who use opioids in Vancouver, BC.” As an expert on substance use and health services for drug-using populations, she and her team will evaluate expanded prescription guidelines for opioid agonist therapy, and pandemic prescribing, both of which support overdose and COVID-19 prevention efforts.

“Our team will leverage three ongoing large studies that have enrolled more than 2000 people who use drugs in Vancouver and administer a survey to study participants who are using opioids, asking them about access to opioid agonist therapies and pandemic prescribing,” Hayashi explains.

As we understand that COVID-19 and the opioid crises affect communities differently due to uptake and barriers of the interventions, Hayashi wants future and current responses to these crises to use an intersectional lens. These crises are shaped by various social and structural factors that are intertwined, and the responses to these dual issues need to be multifaceted.

“Upstream social and structural factors, such as the criminalization of drug use, racism and poverty, shape people’s vulnerability to preventable deaths,” she explains. “The ongoing opioid crisis is no exception and has been exacerbated by the COVID-19 health emergency, as shown in the record-high numbers of illicit drug toxicity deaths occurring over the last few months.”

Hayashi’s previous experience and research show that expanding prescription guidelines for opioid agonist therapies and preventing treatment interruptions should theoretically help patients stay away from contaminated street opioids. Pandemic prescribing, a new intervention introduced due to the COVID-19 pandemic, aims to replace the street drugs people are using with pharmaceutical alternatives.

These interventions seek to reduce physical encounters involved in obtaining illicit drugs and the consumption of toxic street drugs, thereby supporting both overdose and COVID-19 prevention efforts. However, it is unclear if the current and expanded dosing guidelines respond to this new reality, and her team’s research aims to explore the possible early impacts of these two interventions.

“Anecdotal reports indicate that the implementation of pandemic prescribing has been challenging, as it has been met with opposition from some physicians largely due to a lack of scientific evidence supporting the effectiveness of the intervention,” she explains. “Our project undertakes preliminary evaluation of the interventions in urban Vancouver where the interventions seem to have been implemented to a greater extent compared to other settings in the province.”