Implementing Supervised Consumption Services at the Royal Alexandra Hospital: Staff perspectives

When people who use drugs come into the hospital, they are often expected to abstain from drug use for the duration of their stay. However, even with maximal medical interventions for pain and withdrawal, some patients continue to use drugs while hospitalized. This can result in substance-related risk behaviours, premature discharge, or leaving against medical advice. Leaving the hospital against medical advice before their treatment is completed, either voluntarily or involuntarily, often leads to readmission to the hospital in the future. In addition, the expectation of abstinence often results in people who use drugs delaying coming to the hospital, until their health condition is more serious, before seeking medical treatment.

The Royal Alexandra Hospital (RAH) implemented the first supervised consumption service (SCS) for in-patients at an acute care hospital. There is little evidence available for implementation best practices; therefore, we are conducting a pre-implementation study to collect data on hospital staff perspectives on the practical aspects of integrating SCS into the acute care setting. Specifically, we aim to:

1) Explore perspectives on the SCS being embedded within the RAH

2) Identify specific SCS policies and procedures that are acceptable, and

3) Develop a service model to meet the needs of staff and patients