Implementation facilitators and barriers to the expansion of a peer-led overdose prevention program

Abstract

In Canada, there has been a substantial increase of opioid overdoses in recent years. PROFAN, a peer-led overdose prevention initiative, was successfully implemented in Montreal, Quebec, for people who use drugs (PWUD), or those likely to witness overdoses. The worsening of the situation during the COVID-19 pandemic sparked the need to expand the program across the province. Individual interviews were conducted with 17 key informants from 12 health regions to identify implementation facilitators and barriers. A thematic analysis was conducted based on emerging themes. Four main facilitators were reported: 1) presence of an active peer network involved with harm reduction in the region, 2) collaboration among community and public health sectors, 3) stakeholders’ awareness of opioid situation, and 4) perceived appropriateness of training. Six main barriers also emerged: 1) geographical isolation, 2) existing offer of similar services, 3) difficulty reaching isolated PWUD, 4) stigmatization of PWUD, 5) unwillingness of stakeholders to address situation, and 6) lack of funding stability. The expansion achieved by the PROFAN program highlights the ability of a peer-driven community organization to lead an overdose prevention program when provided with funding and support from government health agencies and partnerships with other organizations such as addiction worker associations.

Keywords:

• Opioids
• overdose prevention
• facilitators
• barriers
• implementation
• peers

Acknowledgments

The authors thank all participants from the study, as well as Méta d’Âme and the PROFAN team for their collaboration. The authors also thank Adriana Gentile for her assistance with document formatting.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by funding from Méta d’Âme, the community organization that initiated the PROFAN training program. At their request, the current study was conducted by the research team to provide information for quality improvement of their program, including its implementation and evaluation by all stakeholders. Funding for the writing of this article was obtained from the Canadian Research Initiative in Substance Misuse (CRISM) Quebec-Atlantic node.