Understanding the barriers and facilitators to implementing and sustaining Mobile Overdose Response Services from the perspective of Canadian key interest groups: A qualitative study.

Abstract

Abstract Introduction: Unregulated supply of fentanyl and adulterants continues to fuel the opioid epidemic across the globe. Mobile Overdose Response Services (MORS) are novel technologies that offer virtual supervised consumption (including hotline and mobile applications) to minimize the risk of fatal overdose for those who are unable to access a physical supervised consumption site. However, as newly implemented services, they are also faced with numerous limitations. The objective of this study was to examine the facilitators and barriers to the adoption and implementation of MORS in the context of the current drug poisoning crisis in Canada. Methods: A total of 64 semi-structured interviews were conducted between November 2021 and April 2022. Participants consisted of individuals with lived or living experience of substance use (i.e. peers), family members, health care providers, harm reduction workers, members of the general public, and MORS operators. Inductive thematic analysis informed by grounded theory was used to identify major themes and subthemes. Results: Respondents revealed that MORS facilitated a safe, trauma-informed environment for PWUS to seek harm reduction and other necessary support. It also created a new sense of purpose for operators to positively contribute to the community. However, barriers to adoption of MORS included uncertainty of funding, lacking marketing strategies, and compassion fatigue amongst the workers. Conclusion: Although MORS were viewed as a useful addition to the currently existing harm reduction toolkit, its barriers to adoption must be continuously examined and monitored in various contexts by engaging the perspectives of key interest groups.