Absolutely. This is what we've seen over and over again. I run a cohort study of people who use drugs in Toronto. We followed them for about five years. There is evidence from cohort studies of people who use drugs in Vancouver and Montreal as well, and housing is one of the key factors that is placing people at risk of overdose.
It's interesting, because we see housing in the news every day, but rarely do people put the links together between the housing crisis that is affecting all of Canada and the fact that this is also really contributing to the overdose epidemic that we're experiencing as well. It's very difficult for people to engage in treatment if they are unhoused.
There is often a requirement that people—often an informal or an implicit requirement—be housed prior to receiving standard treatment because their clinicians believe that they may be too chaotic to actually be able to undertake or be retained in a treatment program. I think you really hit the nail on the head that housing goes hand in hand, and unfortunately when resources are being allocated towards ending the overdose epidemic, this issue of housing really does not come up.
We have a shelter system across Canada that is generally abstinence-based. This means that if somebody is managing their substance use through a methadone or buprenorphine program or some other program, but they're still potentially using a little bit of unregulated opioids, they're unable to stay in that shelter. There are some restrictions around even accessing low-barrier housing that are causing people to have to make a choice between remaining on treatment or being housed.