Examining opioid agonist treatment (OAT) site operations and early signals of change in the first year of British Columbia's drug decriminalization policy: Insights from a provincial survey.

Abstract

Objective: On January 31, 2023, the province of British Columbia (BC) introduced a 3-year drug decriminalization initiative, with a goal of increasing access, engagement, and retention in drug use treatment. There is limited information on the operational characteristics of opioid agonist treatment (OAT) sites in BC. These data are required to monitor the impacts of decriminalization on these outcomes. This study sought to characterize OAT service operations and examine any preliminary operational changes following decriminalization, from the perspectives of OAT site staff.

Methods: Between March and April 2024, a cross-sectional, online self-report survey was distributed to OAT sites across BC, completed by site representatives. Questions focused on OAT service operations, including service capacity, treatment retention, and clientele demographics, as well as potential changes to service operations due to decriminalization. Data were analyzed descriptively.

Results: A total of 28 OAT sites from across BC completed the survey. Findings suggest that decriminalization has had limited impacts on OAT site operations within the first year of the policy's implementation. However, several sites reported early signals of change related to client socio-demographics, including seeing more male and younger clients, as well as an increase in demand on their staff and resources.

Conclusion: Despite minimal changes to OAT site operations within the first year of BC's decriminalization policy, findings suggest the need for increased staff training on decriminalization and continued investments into OAT to better support the anticipated demand on services if decriminalization is to successfully reach its goal of improving access to treatment.