Bridging the Gap in Harm Reduction Using Mobile Overdose Response Services (MORS) in the Context of the COVID-19 Pandemic: A Qualitative Study

Abstract

The COVID-19 pandemic introduced a myriad of challenges for accessing healthcare services, especially for people who use substances (PWUS). Numerous supervised consumption sites (SCS) across Canada faced shutdowns and reduced operating capacity in order to comply with public health measures, which has exacerbated the mortality rates associated with opioid toxicity. In an effort to reduce the harms associated with these dual public health crises, Mobile Overdose Response Services (MORS) were introduced to allow PWUS to consume substances under virtual supervision. Here, we examine the role of MORS in the context of the pandemic. A total of 59 semi-structured interviews were conducted with relevant interest groups, including PWUS, health care providers, harm reduction workers, and operational experts. Major themes and subthemes were identi ed using inductive thematic analysis informed by grounded theory. Overall, participants felt that the COVID-19 pandemic shifted the public focus away from harm reduction and neglected the needs of PWUS. MORS were regarded as a useful tool to mitigate the closure/reduced capacity of physical SCS, prevent the transmission of COVID-19, and help alleviate the prevailing sense of isolation during public health crises. MORS were seen as a useful and muchnecessary adjunct service to address the unmet needs of physical SCS during the pandemic and beyond.