SPOTLIGHT: Nafeh, et al. 2025. Barriers and facilitators to safer supply pilot program implementation in Canada: a qualitative assessment of service provider perspectives Harm Reduction Journal.
In this study, we examined barriers and facilitators that influenced the implementation of integrated safer supply pilot programs (ISSPP) across Canada.
Methods: Between March 2022 and May 2023, we conducted a qualitative study using semi-structured interviews with key informants from ten ISSPP located in three provinces across Canada. Data analysis and interpretation of findings were guided by the Consolidated Framework for Implementation Research (CFIR). Thematic analysis was used to code transcripts and identify themes.
Results: ISSPP varied greatly in the degree of ancillary and wraparound services provided. Differences existed across the ten programs in terms of eligibility criteria and medication options. Implementation facilitators included low-barrier and client-centered delivery model, ongoing needs assessment through program monitoring and evaluation, integration of wraparound care, partnership with local services to coordinate client care, community buy-in, clinical protocols and standardized practices, and multidisciplinary care teams with motivated staff. Major barriers were a volatile and toxic unregulated drug supply, complicated policy environments, unsustainable funding models, unsupportive regulatory environments, limited medication options, limited physical space, as well as staff shortage.
