Here are our Top 20 research picks for September, a curated selection of new publications we think are especially relevant to the SUHN community. We collected many more papers over the month, so if you want to see the full list, check out our SUHN Monthly Research Round Up.
Top Picks
Featured research debate: Can a supply shock explain the decline in opioid overdoses in North America? International Journal of Drug Policy special issue
In 2025, an article was published in IJDP with the claim that a fentanyl supply shock explained declines in opioid-related deaths in North America. This special edition of IJDP shares 10 commentaries and a response by the original authors. (Note: Several SUHN members are amongst the commentaries’ authors).
Prescribed alternatives / Safer supply
McAdam, E., et al. (2026). Prescribed pharmaceutical alternatives initiative coinciding with reductions in unregulated street opioid use among young people who use drugs: An interrupted time series analysis. Addiction.
Note: Finds that access to prescribed pharmaceutical alternatives coincided with reduced unregulated opioid use among young people who use drugs.
Zhao, B., et al. (2026). Prescribed alternative stimulants among people who use unregulated stimulants: Examining the association between maximum dose reached and medication discontinuation in the first 3 years of implementation in British Columbia, Canada. Addiction.
Note: Higher prescribed-alternative stimulant doses (≥60 mg/day) were associated with longer treatment episodes, but discontinuation remained high and most episodes never reached that dose.
Overdose/Toxicity prevention in shelters and housing
Aryal, S., et al. (2026). Implementation of an In-Shelter Drug Poisoning Management Program in Calgary, Alberta: A Qualitative Study of Staff Perspectives and Experiences. International Journal on Homelessness.
Note: Calgary shelter staff valued the in-shelter drug-poisoning response program, but implementation was hindered by restrictive policies, weak communication, competing organizational needs and harm-reduction tensions.
Somefun, O. D., et al. (2026). Challenges and opportunities in embedding core components of substance use health care into Housing First programs. Frontiers in Public Health.
Note: Housing First stakeholders identified fragmented services, workforce shortages, restrictive policy/funding and stigma as major barriers; integration requires flexible, low-barrier, person-centred care.
MOUD / OAT Treatment
Hossain, M. B., et al. (2026). Timing of Initiation of Methadone Take-Home Dosing. JAMA Internal Medicine.
Note: In a large British Columbia cohort, initiating take-home methadone was associated with lower mortality and lower treatment-discontinuation risk than no take-home dosing; the greatest estimated benefits were seen when take-homes began 5–24 weeks after induction.
Joudrey, P. J. (2026). Initiation of Take-Home Medication Dosing and Methadone Maintenance Treatment Effectiveness. JAMA Internal Medicine.
Note: This is an invited commentary that discusses the policy and clinical implications of new British Columbia evidence on methadone take-home dosing and treatment effectiveness (above article by Hossain).
Wood, E., & Naji, L. (2026). Discerning the Forest From the Trees When Comparing Treatments for Opioid Use Disorder. JAMA Network Open.
Note: Commentary on how treatment comparisons for opioid use disorder can obscure important differences in outcomes, context and patient priorities.
Jeffery, T., et al. (2026). Difficulty accessing substance use treatment among Indigenous people in a Canadian inner city setting. International Indigenous Policy Journal.
Note: Among Indigenous people who use drugs in Vancouver, homelessness, sex work and violence were associated with difficulty accessing treatment; detox and treatment centres were especially hard to access, often because of long waitlists.
Monico, L. L., et al. (2026). Retention in Telehealth-Delivered Buprenorphine Treatment for Opioid Use Disorder: Multistate Retrospective Cohort Study. Journal of Medical Internet Research.
Note: Telehealth buprenorphine retention was 71% at 6 months and remained comparable to or better than national benchmarks; prior buprenorphine exposure predicted higher retention.
Wilson, P., et al. (2026). Acceptance of Opioid Agonist Treatment in Alberta Bed-based Addiction Treatment Services. Canadian Journal of Addiction.
Note: Only 43% of Alberta bed-based addiction treatment services accepted all opioid agonist treatments; 8% accepted none, and nearly one-quarter made negative, false or stigmatizing comments about OAT.
Clinical care - Infections and wound care
Dastjerdi, P., & Ibrahim, S. (2026). Suspected Xylazine-Associated Skin Ulcers in Montreal, Canada: A Case Report on Diagnostic Challenges and Multidisciplinary Care. Cureus.
Note: Case report from Montreal highlighting diagnostic and multidisciplinary-care challenges associated with suspected xylazine-related skin ulcers.
Spadaro, A., et al. (2026). A Narrative Review of Medetomidine Toxicity: an Update for Emergency Medicine. Current Emergency and Hospital Medicine Reports.
Note: The review highlights rapid, potentially severe medetomidine withdrawal—including vomiting, hypertension, tachycardia and altered mental status—as an emerging challenge for emergency care.
Skuras, A. (2026). Beyond Necrosis: Early Recognition of Xylazine-Associated Wounds in Emergency Nursing Practice. Journal of Emergency Nursing.
Note: Highlights early recognition of xylazine-associated wounds in emergency nursing, supporting earlier and less stigmatizing clinical care.
McCann, N. C., et al. (2026). Outcomes of a Program to Support Outpatient Antibiotic Adherence Among People Experiencing Housing Instability With Serious Injection Drug-Related Infections in Boston, MA: A Propensity Score Matched Study. Open Forum Infectious Diseases.
Note: Boston’s BOLT antibiotic-support program was not significantly associated with rehospitalization, patient-directed discharge or ED use compared with matched historical controls.
Harm Reduction
Richardson, M., et al. (2026). Harm reduction approaches within Indigenous communities across Turtle Island: A scoping review of peer-reviewed and grey literature. Harm Reduction Journal.
Note: The review found diverse Indigenous-led, culturally grounded harm-reduction approaches across Turtle Island and argues that future investment must preserve Indigenous leadership, data sovereignty and community-defined success.
Gonzalez-Nieto, P., et al. (2026). Drug sellers' use of a drug checking service amid the overdose crisis in British Columbia, Canada. Addiction
Note: Drug sellers were frequent drug-checking users; 44.8% of their samples contained unexpected substances, supporting sellers as potential harm-reduction partners.
Rioux, W., et al. (2026). Public perspectives on supervised consumption sites across Canada: A cross-sectional study. International Journal of Drug Policy.
Note: Across 2,866 respondents, Canadians generally viewed supervised consumption sites as beneficial for clients and did not perceive overall negative effects on communities or health systems.
Policing and Criminal legal system
Singh Kelsall, T., et al. (2026). Police drug seizures without arrest before and during a decriminalization pilot in Vancouver, Canada: a longitudinal analysis. BMC Public Health.
Note: During BC decriminalization, police drug seizures without arrest increased; experiencing such a seizure was associated with more than threefold higher odds of nonfatal drug toxicity.
Kielhold, K., et al. (2026). Policing and nonfatal overdose in a community-based cohort of sex workers in Vancouver, Canada: influence of stigma and other intersecting systems of marginalization (2014-2024). International Journal of Drug Policy.
Note: Police interactions, displacement and barriers to harm reduction were associated with nonfatal drug toxicity among sex workers in Vancouver, with harms shaped by intersecting stigma and marginalization.
