A qualitative study examining the experiences of people who use drugs in supportive housing in London, Ontario

BackgroundSince 2016, London, Ontario has experienced increasing numbers of opioid overdoses and overdose related deaths. Supportive housing agencies have been especially impacted, experiencing an 890% increase in opioid overdose from 2018-2021. A coalition was formed between London housing agencies and our research team to better understand the perspective of precariously housed participants who use drugs on existing substance use and overdose related policies within housing agencies. We aimed to center participant voices in policy development efforts.MethodsUsing a community-based participatory research framework, 17 participants were interviewed at three housing agencies. Drawing on qualitative descriptive methods, transcripts were subject to content analysis and three themes were identified.ResultsThemes included (1) conflicts between agency rules and resident realities, (2) safe use accessibility, (3) trust and understanding key to facilitating harm reduction.ConclusionTrust and understanding were weaved across all themes and mediated participants' opioid overdose experience and risk of overdose related deaths. We recommend interventions to rebuild trust and foster understanding alongside harm reduction-based policies to reduce overdose related deaths.