Project 462456

Supervised injection service(s) (SIS) are a key strategy to reduce harm from with injection drug use. They provide clean, safe spaces where people inject drugs and receive emergency care if they overdose. Research demonstrates that SIS have positive health outcomes in the community. But their impacts have not been evaluated in acute care hospitals. This is problematic because PWID are frequently hospitalized. Many continue to use drugs while admitted. Hospitals often struggle to meet the needs of PWID, and can become risky places when patients feel they have no option but to use drugs alone or in unsafe areas, reuse and unsafely dispose of needles, or leave before completing their medical treatment. Edmonton's Royal Alexandra Hospital (RAH) has attempted to address these concerns by becoming the first acute care hospital in the world to offer SIS for patients. We plan to evaluate the impacts of the RAH SIS in a two-part study. First, we will collect and analyze data on SIS-related outcomes and patient characteristics among PWID in hospital. Second, we will compare patients who inject in the RAH SIS with patients who inject while hospitalized but receive usual care to see if the SIS improves outcomes. We plan to recruit patients who inject drugs into surveys at the start and end of their hospital visit. We will also collect and analyze data from their hospital records. Our overall aim is to see if using the RAH SIS results in less premature discharge, unattended overdose, unsafe injecting, and hospital-acquired infections. This will be the first study of its kind to assess whether SIS in acute care improve patient outcomes. We expect our results will be highly relevant for other hospitals seeking to ensure PWID have equitable access to safe and effective acute care.