Evidence map›Paper›PMID 41219973›Full record

ArticleHarm reduction journal2025

Exploring disparities: a regional analysis of harm reduction supply distribution and opioid-related deaths across Ontario's Public Health Units.

Shaleesa Ledlie, Kristy Scarfone, Dana Shearer, Nadia Zurba, Miroslav Miskovic, Charlotte Munro, Jes Besharah, Shauna Pinkerton, Tyler Watts, Tara Gomes

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Article in Harm reduction journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Shaleesa Ledlie *Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Kristy Scarfone *Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Dana ShearerLi Ka Shing Knowledge Institute, Unity Health, 30 Bond Street, Toronto, ON, Canada.
Nadia ZurbaOntario Harm Reduction Distribution Program, Kingston Community Health Centres, Kingston, ON, Canada.
Miroslav MiskovicOntario Harm Reduction Distribution Program, Kingston Community Health Centres, Kingston, ON, Canada.
Charlotte MunroOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, ON, Canada.
Jes BesharahOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, ON, Canada.
Shauna PinkertonOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, ON, Canada.
Tyler WattsOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, ON, Canada.
Tara GomesLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada. Tara.Gomes@unityhealth.to.

Funding

CIHR 178163Ontario Ministry of Health 0691
6 · The paper itself

Abstract

backgroundIt is critical that a range of harm reduction supplies are available through Ontario's Public Health Units (PHU) to meet the varying needs of people who use drugs. Therefore, we assessed geographic variation in opioid-related deaths and the distribution of these harm reduction supplies among 34 PHUs in Ontario, Canada.

methodsWe conducted a population-based repeated cross-sectional study using publicly available administrative datasets between January 1, 2019, and December 31, 2022. Rates of opioid-related deaths and the distribution of harm reduction supplies (inhalation supplies, naloxone, and needles provided) were calculated per PHU. Small area rate variation statistics including the extremal quotient (EQ) were used to assess variation across PHUs in 2022.

resultsOver the study period, the quarterly number of opioid-related deaths increased by 40.6% (3.2 to 4.5 per 100,000) in Ontario. The distribution rate of all harm reduction supplies increased, although there was considerable variation by type of supply. For example, the EQ ranged from 34.7 for naloxone to 1,610.6 for foil. In 2022, there were three PHUs with significantly higher rates of opioid-related deaths compared to the provincial average. In general, these PHUs also had significantly higher distribution rates of naloxone, needles, and inhalation supplies.

conclusionsAcross Ontario, there is high variability in harm reduction supply distribution and opioid-related mortality. Regions with elevated opioid-related death rates also had high supply distribution rates, suggesting that efforts are concentrated in regions with particular need. To minimize harms related to substance use, ongoing efforts are needed to ensure a clear understanding of community-based needs for harm reduction services.

Indexed as

Harm ReductionNaloxoneNarcotic AntagonistsNeedle-Exchange ProgramsOpioid-Related DisordersCross-Sectional StudiesHumansOntarioPublic Health PracticeSmoking DevicesNaloxoneNarcotic AntagonistsDrug overdoseHarm reductionNaloxoneNeedle exchange programsOpioidsPublic health

Identifiers

PMID41219973
PMCPMC12606891

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.