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EV0034

Health service use and mortality following the closure of an overdose prevention site: a quasi-experimental study using linked administrative data

HEALTHCARE UTILIZATION AND MORTALITY FOLLOWING OVERDOSE PREVENTION SITE CLOSURE: A QUASI-EXPERIMENTAL STUDY USING LINKED ADMINISTRATIVE DATA

Following the announcement of the overdose prevention site's closure, opioid agonist therapy dispensing increased and remained elevated, while no significant short-term changes were detected in emergency department visits, opioid-related emergency medical events, or mortality.

The study aimed to examine opioid agonist therapy (OAT) dispensing, acute health service use, and mortality following the closure of the Red Deer overdose prevention site (OPS) in Alberta, compared with service users at the Lethbridge site, which continued to operate without interruption. Using a retrospective cohort design, provincial administrative data were linked for individuals with a personal health number who had used supervised consumption services at least once in Red Deer (n=381) or Lethbridge (n=300). Weekly rates of at least one OAT dispensation, emergency department (ED) visit, inpatient admission, suspected opioid-related emergency medical services (EMS) event, and death were measured from June 30, 2024, to approximately six months after the Red Deer site's closure (September 27, 2025). The pre-announcement (June 30, 2024, to September 28, 2024), announcement-to-closure (September 29, 2024, to March 29, 2025), and post-closure (March 30, 2025, to September 27, 2025) periods were compared using segmented difference-in-differences interrupted time series (DID-ITS) models; a within-site interrupted time series analysis was also conducted for Red Deer. Following the closure announcement, weekly OAT dispensing increased significantly and remained elevated throughout the post-announcement period. Although the slope flattened after closure, dispensing remained above pre-announcement levels, and post-closure OAT use was higher in Red Deer than in Lethbridge. The segmented DID-ITS models detected no differential post-closure changes in ED or EMS outcomes between the two sites, and deaths remained infrequent throughout follow-up (6 deaths before closure and 5 after closure). Limitations included the relatively short post-closure follow-up period, reduced statistical power due to the small number of deaths, and the lack of analyses of OAT dispensing by medication or treatment duration; longer follow-up is needed to assess the sustainability of treatment engagement.

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