Trends, characteristics, and circumstances surrounding stimulant toxicity deaths in Ontario, Canada from 2018 to 2021.

Introduction: As the drug toxicity crisis continues to evolve globally, harms related to non-opioid substances, including stimulants, have risen in parallel. Our study aims were to describe trends in accidental stimulant toxicity deaths and to characterize demographic characteristics of decedents and the circumstances surrounding death.

Methods: We conducted a population-based repeated cross-sectional study, of all accidental stimulant toxicity deaths between January 1, 2018, and December 31, 2021, in Ontario, Canada.

The refinement paradox and cumulative cultural evolution: Complex products of collective improvement favor conformist outcomes, blind copying, and hyper-credulity.

Social learning is common in nature, yet cumulative culture (where knowledge and technology increase in complexity and diversity over time) appears restricted to humans. To understand why, we organized a computer tournament in which programmed entries specified when to learn new knowledge and when to refine (i.e.

Cohort study of team-based care among marginalized people who use drugs in Ottawa.

Objective: To describe team-based care use among a cohort of people who use drugs (PWUD) and to determine factors associated with receipt of team-based care.

Design: A cohort study using survey data collected between March and December 2013. These data were then linked to provincial-level health administrative databases to assess patterns of primary care among PWUD in the 2 years before survey completion.

A cross-sectional study of factors associated with unstable housing among marginalized people who use drugs in Ottawa, Canada.

Introduction: Housing affects an individual's physical and mental health, particularly among people who use substances. Understanding the association between individual characteristics and housing status can inform housing policy and help optimize the care of people who use drugs. The objective of this study was to explore the factors associated with unstable housing among people who use drugs in Ottawa.

Engagement in primary health care among marginalized people who use drugs in Ottawa, Canada.

Background: There may be less primary health care engagement among people who use drugs (PWUD) than among the general population, even though the former have greater comorbidity and more frequent use of emergency department care. We investigated factors associated with primary care engagement among PWUD.

Methods: The Participatory Research in Ottawa: Understanding Drugs (PROUD) cohort study meaningfully engaged and trained people with lived experience to recruit and survey marginalized PWUD between March-December 2013.

A cross-sectional study of prolonged disengagement from clinic among people with HCV receiving care in a low-threshold, multidisciplinary clinic.

Background: Disengagement from care can affect treatment outcomes of patients with hepatitis C virus (HCV). We assessed the extent and determinants of disengagement among HCV patients receiving care at the Ottawa Hospital Viral Hepatitis Program (TOHVHP).

Methods: We linked clinical data of adult patients, categorized as ever or never disengaged from clinic (no TOHVHP encounters over 18 months), receiving care between April 1, 2002, and October 1, 2015, to provincial health administrative databases and calculated primary care use in the year after disengagement.

Correction to: HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study.

After publication of the original article [1], we were notified that an author's name has been incorrectly spelled. Jeff Kwong's full name is Jeffery C. Kwong.

HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study.

Background: Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment uptake and cure in the pre- and post-direct acting antiviral (DAA) era.

Hepatitis C Testing, Status and Treatment among Marginalized People Who Use Drugs in an Inner City Setting: An Observational Cohort Study.

Background: Chronic hepatitis C virus (HCV) infection is common among people who inject drugs (PWID) and is associated with morbidity and premature death. Although HCV can be cured, treatment may be inaccessible. We studied HCV testing, status and treatment among marginalized people who use drugs in Ottawa, Canada, a setting with universal insurance coverage for physician services.

A cohort study examining emergency department visits and hospital admissions among people who use drugs in Ottawa, Canada.

Background: The health of people who use drugs (PWUD) is characterized by multimorbidity and chronicity of health conditions, necessitating an understanding of their health care utilization. The objective of this study was to evaluate emergency department (ED) visits and hospital admissions among a cohort of PWUD.

Methods: We used a retrospective observational design between 2012 and 2013.

Housing First for Adults with Problematic Substance Use.

Objectives: This study explores the two-year housing- and non-housing-related outcomes for adults who are homeless with problematic substance use who received scattered-site housing and intensive case management services from a Housing First program in Ottawa, Canada, in comparison with a group of adults who are homeless with problematic substance use who had access to standard care in the community.

Methods: Housing First clients (n = 89) and members of a comparison group (n = 89) completed structured interviews at baseline and were followed for two years.

Results: Housing First clients moved into housing more quickly, reported a greater proportion of time housed, were more likely to spend the final six months housed, and had longer housing tenure at 24 months.