Learning objectives:

1. Recognize opportunities to incorporate multiple services, especially mobile approaches, alongside OAT to increase flexibility, reduce barriers and improve access to our most vulnerable and severe OUD patients.
2. Identify what novel harm reduction strategies were employed at the iOAT and ODP program in Calgary in response to the double crisis of the Covid 19 pandemic as well as increasing overdose rates from a toxic drug supply.
3.  

Abstract:

The Calgary Injectable Opioid Agonist Therapy (iOAT) and Opioid Dependency (ODP) programs faced an onslaught of challenges starting in 2020. From the COVID-19 pandemic to a mandated merging of services by government funders, the programs faced a rapid transition to virtual care and other social distancing measures amid mounting opioid overdoses. The beginning of the pandemic saw the creation of a Mobile Opioid Agonist Therapy (MOAT) team to address the needs of the most vulnerable clients. By spring 2021 iOAT and ODP merged, bringing a full spectrum of new harm reduction strategies and treatment programs together within one service. Methods: Prior to the merge, the 2 programs had different approaches with ODP providing only long acting approved opioid agonist therapy (OAT) medications while iOAT provided both long and short acting opioids. The pandemic resulted in the need to develop more novel harm reduction strategies requiring program adjustments. Most significantly it was noted that the need for mobile outreach services continued to grow even during the re-opening phases of the pandemic. Changes to the use of opioids other than the usual OAT medications had to be made while incorporating an enhanced psychosocial support as well as treatment for bloodborne infections like hepatitis C and HIV. Results: The MOAT program was a catalyst for change at ODP, allowing improved access to OAT as well as ‘one-stop services such as hepatitis C treatment, episodic primary care, and mental health supports. Many creative strategies were employed to engage with the most vulnerable clients who were at greatest risk of harm related to the current toxic drug supply. Conclusions: Harm reduction and treatment programs can effectively blend services and adapt approaches, in the face of opposing ideological views. ODP developed flexible services that met clients in their communities, reduced barriers to care, and increased access to effective treatment strategies for opioid use and its complications.