Prescribed safer supply dispensing machine can facilitate access, reduce overdose risk: Study

published on May 14, 2023

Dispensing pharmaceutical-grade opioids through a biometric dispensing machine can be an effective low-barrier model for the delivery of prescribed safer supply, according to research published today in the Canadian Medical Association Journal (CMAJ). However, research authors caution, the program has limitations which should be considered before expanding.

The research is the first evaluation of participant experiences with MySafe, a Health Canada-funded program started in Vancouver using secure biometric dispensing machines to administer tablet hydromorphone daily to individuals at high risk of overdose.

Participants reported that the MySafe program allowed for greater accessibility and flexibility with dosing and dispensation. Participants also reported that it reduced drug-related harms and promoted positive outcomes including reduced illicit drug use, decreased overdose risk, positive financial impacts, and improvements in health and wellbeing. However, barriers were cited as well, including technological issues with the dispensing machine, dosing challenges, and prescriptions being tied to individual machines.

“These findings suggest this service delivery model may be able to circumvent barriers that exist at other prescribed safer supply programs and may enable access to safer supply in settings where this may otherwise be limited,” says lead author Dr. Geoff Bardwell, a research scientist with the BC Centre on Substance (BCCSU) and assistant professor at the University of Waterloo. “That might include rural and remote settings, where access to healthcare, including pharmacies, can be very limited.”

Researchers from BCCSU, University of British Columbia, and University of Waterloo interviewed 46 participants at three MySafe sites in Vancouver who were enrolled in the program for at least one month.

In order to qualify for the program, participants undergo a full medical and social assessment which includes current drug use patterns and their risk of overdose. A physician may then prescribe hydromorphone tablets that are prepared by a pharmacy and pre-packaged to fit into the MySafe machine. Prescriptions are dispensed from machines in secure, staffed locations using biometric technology.

Facilitators and barriers to access

“The success of the MySafe Program goes beyond simply giving people a regulated opioid supply. It is non-judgemental, convenient, and provides people with some degree of control and autonomy,” says Dr. Mark Tyndall, founder and director of the MySafe Project.

Among the facilitators cited by program participants were accessibility, lack of consequences for missing doses, and judgement-free service. In addition, unlike other prescribed safer supply programs, access to non-witnessed doses was cited as a program benefit.

On the other hand, issues with the technology – including instances when prescriptions would not be dispensed resulting in participants having to rely on the unregulated drug supply – and prescriptions being tied to one individual machine were seen as limitations with the program. Dosing and medication were also cited as a challenge, as prescribed doses of hydromorphone were not equivalent to fentanyl in the unregulated drug supply and may not meet the needs of participants. As a result, the program did not completely eliminate some individuals’ reliance on the unregulated drug supply, with some reporting they experienced overdose while consuming non-prescribed substances.

While overall the findings demonstrate the potential of this service model to support access to prescribed safer supply and improve outcomes, researchers cautioned the findings are preliminary and longitudinal analysis is still needed to understand long-term outcomes.

“Within the context of the toxic, unregulated drug supply that is killing thousands of people every year, there is a continued and urgent need to implement and evaluate novel interventions like MySafe to address overdose risk,” says Dr. Thomas Kerr, study senior author and director of research at BCCSU.

Read the full study here:



Media inquiries:
Kevin Hollett, BC Centre on Substance Use
[email protected]