“Anybody who Looks at This Program and Doesn’t See the Positive Side from it Doesn’t Fully Understand”: Participant Perspectives on an Injectable Opioid Agonist Treatment Program in New Brunswick, Canada

Safer supply programs (SSPs) have emerged in Canada in a response to the drug toxicity crisis and to the contaminated illicit drug supply. A form of safer supply, injectable opioid agonist treatment (iOAT) programs, provide individuals with access to regulated opioids that are generally self-administered in supervised settings. The implementation of SSPs has been controversial, and gathering additional data on their impact is necessary to inform their future. An iOAT program in New Brunswick, Canada, was evaluated from the perspectives of individuals accessing the program, to better understand program experiences, impacts, and barriers. Semistructured interviews were completed with iOAT participants ( N = 21) who had been in the program for approximately six months. An Interpretive Phenomenological Analysis was used to understand the experiences of participants in the program. Participants reported positive experiences that were associated with the program's low-threshold and nonstigmatizing environment. Impacts such as improvements in mental health, increased financial stability, decreased engagement in criminal activities, and reduced use of substances from the illicit market were reported. Challenges associated with program involvement included inadequacies in the strength of available medications, negative impacts from interruptions to safer supply (e.g., from being arrested or hospitalized), and barriers to access (e.g., transportation and daily attendance). The findings from this study demonstrate the importance of SSPs as a vital option in the care of people who use drugs and identify the need for wraparound health services as well as increased continuity of care from SPPs to services available in healthcare and criminal justice settings.