Evaluating the Supervised Consumption and Overdose Prevention Effects on British Columbias overdose epidemic: SCOPE study
The objective of our project is to conduct a comprehensive evaluation of the effects (including intended and unintended positive and negative consequences) of the newly implemented OPSs and SCSs on opioid overdose related events, health outcomes, and health services used. To meet the project objective, we will conduct a) an exploratory analysis of the disease and health system burdens of severe opioid overdose events in British Columbia; b) a set of epidemiologic analyses estimating the risk of overdose related sequelae by overdose exposure, and the hazards of repeat overdose events on developing a sequela; and c) an evaluation of the effects of the new SCSs and OPSs on overdose-related hospitalization, sequelae, and mortality events, and health services used using Pechansky and Thomas access to care framework.
Our null hypotheses are:
a) Exploratory analysis:
a. Exposure to an opioid overdose event is not associated with differences in health service utilization in the subsequent twelve months;
b) Epidemiologic analyses:
a. Exposure to an opioid overdose event is not associated with a risk of developing an overdose-related sequela (first identified as part of the exploratory analysis);
b. Repeat opioid overdose is not associated with a change in hazards of mortality or overdose-related sequelae;
c) Evaluation of the effects of interventions:
a. The operation of the new SCSs and OPSs (in general, and by type) has had no observable effect on the incidence of opioid overdose related health outcomes (mortality, sequela), or health service use (events attended by paramedics, with emergency department visits, hospitalized, and intensive care unit (ICU) admission); but
b. If effect(s) are observed, they do not change with proximity to the SCSs/OPSs.
For our analyses, no adjustment will be made for multiple comparisons using the same cohort.