Housing and overdose risk environments: A community-based participatory research study

Drug overdose deaths are the most pressing public health challenges in North America, which is currently experiencing an overdose epidemic. The proliferation of fentanyl-adulterated opioids and related analogues have given rise to an unprecedented overdose crisis, with opioid-related overdoses now the leading cause of accidental death in North America. The overdose crisis has been particularly severe in the province of British Columbia (BC) in Canada, leading to the provincial declaration of a public health emergency in April 2016. Currently, the housing crisis in Vancouver and elsewhere in the province is overlapping with the provincial overdose crisis. In response, novel harm reduction and addiction treatment interventions are now being implemented in housing environments. Building upon our extensive experience in examining social-structural influences on drug-related risks and harms, we are requesting funds to support a four-year program of community-based participatory research to address the following objectives: (1) To examine the implementation and impact of overdose-focused interventions within housing environments and their impacts on overdose-related outcomes; (2) To examine how intersecting social, structural, and environmental forces within housing environments shape overdose risk environments among people who use drugs; and (3) To explore the dynamics of peer and tenant involvement in the implementation and operation of overdose-focused interventions within housing environments