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Featured Publications
Haines, Hill, and O’Byrne. 2025. Safer Supply: Program Discontinuation and re-engagement. IJDP.
30 people participated in this study. From interviews, seven themes arose on the topic of diversion, including 1) diversion in the context of being a person who uses drugs, 2) safety, 3) compassion, 4) meeting needs, 5) survival, 6) coercion, and 7) protecting youth.
Discussions with participants highlighted the importance of understanding why medication diversion occurs. Important factors influencing medication diversion included the need for safety, compassion, meeting needs, survival, and coercion faced by people who use drugs. Ultimately, medication diversion can be best understood as a measure implemented by people who use drugs to protect and care for their underserved community.
Haines, Hill, and O’Byrne. 2025. Safer Supply: Program Discontinuation and re-engagement. Journal of Drug Issues
A qualitative study with safer supply participants was conducted to better understand program discontinuation, re-engagement, and barriers to care from their perspective. Semi-structured interviews and surveys were completed with participants. Overall, 30 individuals participated in this study. Three major themes were brought up by research participants, which include: (1) safer supply program entry, (2) safer supply program experiences, and (3) the program restart process. Discussions with participants highlighted the importance of recognizing that times of crisis are inevitable and may potentially threaten participant program retention. Having clear program processes in place, increased wrap-around services, and flexibility when provisioning care are essential components of safer supply programs.
Reider, TN. 2025. Ethical justifications for safe supply interventions. IJDP.
The argument in favor of providing people who use drugs with a pure, regulated supply—an intervention often called “safe supply”—is very straightforward. North America is in the midst of a drug overdose crisis, driven largely by a toxic illicit drug supply. The solution practically presents itself, then: we could just give people access to pure, pharmaceutical-grade drugs, so they know what they're getting and can dose accurately. This idea that we need a “safe supply” is essentially harm reductionist: since people will use drugs, we should do what we can to reduce the secondary harms of that use. Although there is some risk inherent in taking drugs like opioids, those risks are massively increased by the toxic supply, and that's a risk we can mitigate. So we should.
Although the argument is clear and simple, it has not proved very successful in North America. The deep divide between advocates of safe supply (who see it as straightforwardly implied by plausible harm reduction commitments) and opponents of any form of harm reduction (who still adhere to a War on Drugs approach) has made it possible to avoid conducting a more nuanced ethical analysis of safe supply interventions. Thus, I want to suggest that we move past the most radical positions on the permissibility of safe supply, and instead evaluate the ethical issues that arise when we consider the concrete tradeoffs that arise with specific proposals. In particular, I will argue that a crucially important question for evaluating the ethics of a candidate safe supply intervention concerns the actual mechanism of supply, which determines how “low barrier” the intervention is.
Whitfield, M.M., et al. 2025. Nurse Practitioner Conceptions of Capability Providing Medication and Safe Supply for Opioid Use Disorder in Primary Care: A Phenomenographic Study Journal of Advanced Nursing.
Semi-structured interviews were conducted with 21 nurse practitioners via Zoom between July and September 2022 to elicit participant experiences and understanding of capability development when treating opioid use disorder. Participants worked in primary care settings in New England, United States and Ontario, Canada. Data was analysed using a phenomenographic approach.
Five categories of description representing conceptions of capability development in treating opioid use disorder were identified through iterative data analysis. Capability development was experienced as a process of developing foundational practice knowledge; integrating knowledge with existing practices; evolving practice perspectives; adaptation of practice and becoming expert.
Capability attributes included creative thinking, risk taking and adapting existing practice in the service of person-centered care and harm reduction.
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