Expanding supervised consumption services in rural Canada: Bridging gaps.

Supervised consumption services (SCS) and overdose prevention services (OPS) are core interventions for reducing risks of overdose death, HIV, and hepatitis C (HCV) and supporting the health of people who use drugs. However, most SCS/OPS are concentrated in major urban centres. There is an urgent need for the expansion of SCS/OPS in rural and small population centres across Canada, particularly given rising rates of drug-related mortality and morbidity in these settings. This commentary outlines current knowledge of SCS based in rural and small population centres, including availability and key barriers and facilitators of implementation and access. To support a public health approach that reduces drug-related mortality and morbidity, further research is needed on scaling up SCS/OPS in communities of all sizes. Alternative delivery models, including virtual and mobile, and the role of informal peer networks have the potential to enhance SCS/OPS in rural and other low resource settings.