Setting Substance use remains a pervasive public health issue throughout Canada, exerting substantial economic, social, and political pressure on health care systems, while impacting lives of affected individuals. The advent of COVID-19 has been doubly perilous; it restricts existing programming, while exacting a worsening toll on mental health and substance use fronts across the demographic landscape. Intervention In response to the crisis, the Mobile Withdrawal Management Service (MWMS) was established in 2019 through a Winnipeg-based community health centre. MWMS is a community-based outreach withdrawal service that supports individuals for up to 30 days. Clients may choose where services are accessed in the community, including their own home. For those without safe housing, short-term accommodation is offered. Additionally, Indigenous cultural support, peer support, trauma counselling, and linkage to primary care are available. Outcomes The MWMS approach is resolutely patient-centred. The program meets people where they are at, both figuratively and literally. Agility and adaptability—particularly in the context of substance use treatment—is uniquely advantageous in maintaining service delivery to the broad demographic cross-section revealed in the data. Moreover, relative to inpatient detoxification services, MWMS holds significant potential for system-wide cost savings. Implications The presented approach addresses a significant gap in addiction services. There is substantial capacity for both increased access and system savings with implementation of this approach. Furthermore, the principles behind the program are readily transferable to different contexts and easily modifiable to local conditions. There is particular potential for servicing hard-to-reach populations, with respect to both physical and social geography.

Despite the sweeping and deep-rooted impacts of problematic substance use throughout Canada, services remain under-resourced and overwhelmed.  Innovative approaches are required if meaningful change is to occur.  In this paper, we examine the incorporation of peer support into a novel, community-based outreach withdrawal program which engages with participants where they are situated. Peer support is an evidence-based intervention utilized in a wide range of health care arenas.  It employs lived experience as a skillset to address health care needs to complement other components in the therapeutic journey. In the context of an outreach withdrawal service, peer support holds potential to deconstruct the power dynamic that acts as a barrier in conventional withdrawal programs.  Peer support    promotes the concept of interdisciplinary care, while actively dismantling stigma.  More research is required to evaluate outcomes, client satisfaction, and cost-effectiveness with regards to peer support interventions in community-based outreach detoxification programming.