"This is a clinical program for social problems" – Exploring Emerging Modes of Governance and Care in Safer Opioid Supply (SOS) Programs Through Interviews with Clients and Providers

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A profile photo of Adrian Guta ARCSHS invites you to a research and practice seminar with Associate Professor Adrian Guta.

Wednesday 16 March 2022 11:00 am (Add to calendar)
Dr Stephanie Lusby
Presented by:
Associate Professor Adrian Guta
Type of Event:
Public Lecture; Seminar/Workshop/Training; Public

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Drawing on a "government of things" approach, we examine Canadian "safer opioid supply" (SOS) programs that were scaled up in the context of the COVID-19 pandemic. While safer supply is a broader movement calling for the legalization of all drugs, Canada is piloting medicalized SOS programs that provide individuals who use illicit opioids with an 'off label' prescription for pharmaceutical-grade alternatives. These SOS programs are a response to the national crisis of opioid overdose deaths with origins in physician overprescribing and more recently due to a drug supply contaminated with fentanyl and its analogues. In this presentation, we share preliminary findings from interviews with 27 clinical and allied health providers (e.g., physicians, nurse practitioners, nurses, social workers, and pharmacists) and 53 clients sampled from 4 SOS programs in Ontario, Canada where SOS is typically provided in a primary care model. Our analysis considers theoretical insights from Foucauldian governmentality studies and the material turn in critical drug studies to make sense of our data. The SOS programs we heard from privileged “high acuity” clients with a history of overdose and provided daily observed oral slow-release morphine and hydromorphone to be taken and used later as preferred. While providers and clients described SOS as "life saving,” and a mechanism through which to respond to health and sociomaterial dis/advantage, these programs struggle to offset illicit fentanyl and meet a “sea of need.” Within the constraints of medicalized SOS, providers have limited prescribing options, and clients must undergo routine monitoring and remain engaged in care, which restricts program reach. We will discuss these and other issues in greater detail and reflect on our experience of conducting research during the pandemic.

About Associate Professor Adrian Guta

Adrian Guta is an Associate Professor of Social Work at the University of Windsor, in Ontario Canada. His interdisciplinary research examines health equity, ethics, and community engagement. He has worked with numerous clinical and community partners to undertake collaborative research about the health and wellness needs of people living with and affected by HIV and people who use drugs.


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La Trobe University



30th Sep 2022 2:13pm

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