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Faculty of Graduate Studies

Hannah Heide

  • M.A. (Yorkville University, 2020)
  • B.A. (University of Winnipeg, 2020)
Notice of the Final Oral Examination for the Degree of Master of Public Health

Topic

Examining the Impacts of Supplementary Health and Social Supports Within Prescribed Safer Supply Programs in British Columbia: A Longitudinal Analysis

School of Public Health and Social Policy

Date & location

  • Friday, August 14, 2026
  • 10:00 A.M.
  • Virtual Defence

Examining Committee

Supervisory Committee

  • Dr. Karen Urbanoski, School of Public Health and Social Policy, University of Victoria (Supervisor)
  • Dr. Catherine Worthington, School of Public Health and Social Policy, UVic (Member)

External Examiner

  • Dr. Heather Palis, School of Population and Public Health, University of British Columbia

Chair of Oral Examination

  • Dr. Stephen Lindsay, Department of Psychology, UVic

Abstract

Background. Prescribed safer supply (PSS) programs aim to reduce harms from the toxic unregulated drug supply by providing regulated pharmaceutical alternatives. Program models vary in whether and how they integrate wraparound supports such as housing, income, and healthcare navigation. Whether these supplementary supports are associated with short-term health outcomes among PSS clients remains uncertain. The objective of this study was to examine whether supplementary wraparound supports are associated with short-term health outcomes among clients of prescribed safer supply programs.

Methods. Secondary analysis of longitudinal survey data from the Provincial Evaluation of Prescribed Safer Supply in BC, a cohort study of PSS clients in British Columbia with baseline and 2-, 4-, and 6-month follow-up surveys. Of 511 enrolled participants, 251 contributed at least one valid lagged exposure–outcome pair and formed the analytic-eligible cohort. The exposure was self-reported receipt, in the prior two months of provider help with healthcare access or connection to services such as income assistance, housing, or parenting support, modelled as time-varying and lagged one wave. Outcomes were self-reported non-fatal overdose in the prior two months and EQ-5D-5L health utility scores. Generalized estimating equations adjusted for baseline sociodemographic, mental health, substance use, and program-related covariates.

Results. At baseline, 15.4% of participants reported a recent non-fatal overdose and mean EQ-5D-5L health utility was 0.67. In adjusted models, prior-wave supplementary supports were not associated with non-fatal overdose (AOR = 0.80; 95% CI: 0.43, 1.49; p = 0.49; n = 215 participants, 375 person-waves) or with EQ-5D-5L health utility (b = −0.018; 95% CI: −0.066, 0.030; p = 0.47; n = 210 participants, 361 person-waves). Baseline housing instability was associated with elevated odds of non-fatal overdose (AOR = 2.06; 95% CI: 1.04, 4.08; p = 0.039), and higher PHQ-2 depression scores were associated with lower health utility (b = −0.040 per point; p < 0.001). Sensitivity analyses using an ordinal exposure coding and a categorical time parameterization produced substantively unchanged effect estimates.

Conclusions. In this longitudinal cohort, the receipt of brief supplementary supports from PSS providers was not detectably associated with short-term non-fatal overdose or health-related quality of life. Baseline housing instability and depressive symptoms were associated with poorer outcomes during follow-up.

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