Drug Use and Overdose Response  

For information on harm reduction and human rights in light of COVID-19, visit our COVID-19 resources page.

 


BC’s overdose epidemic was declared a public health emergency in April 2016. This has significant impact on first responders, including frontline staff at Pacific AIDS Network (PAN) member and allied organizations, and especially people with lived experience (PWLE).

Responding to overdoses is one small piece of healthcare and advocacy services. PAN’s report, Canadian Drug Policy, Supervised Consumption Sites and Provincial Response to the Public Health Crisis of Overdose Deaths, was developed to identify key action areas for going forward. One of these action areas was addressing the needs of our member organizations.

PAN executed further assessment of community needs: Responding to the Overdose Crisis in British Columbia: A Rapid Assessment of Frontline/ Community-Based Organizations’ Capacity-and-Skills-Building Needs. The resources provided here reflect resource requests and the Rapid Assessment research findings. We provide updates through Substance Use News blogs, build on these resources and welcome feedback.

 

Explore sections (click the title)

Substance Use News
Harm Reduction Instead of Criminalization
Overdose Prevention, Care and Recovery
Peer Voices and Resources
Harm Reduction
Grief, Loss and Resilience
The Fight Against Stigma
Treatment Resources and Care
Reports, Recommendations, and Research


Substance Use News

Our Substance Use News provides a snapshot of news and resources for those working to support folks who use substances. We share pieces on the social, medical and political responses to the opioid crisis, from advocacy to welcome change. 

2020

June 2020 | May 2020 | April 2020 | March 2020 | February 2020 | January 2020

2019

December 2019 |  November 2019 | October 2019 | September 2019August 2019  | July 2019  |  June 2019   Ι   May 2019   Ι   April 2019   Ι   March 2019  Ι   February 2019   Ι   January 2019

2018
November 2018  Ι  August 2018  Ι  May 2018   Ι  March 2018  Ι  January 2018

2017
December 2017  Ι  November 2017   Ι  September 2017    Summer 2017   Ι  June 2017
May 2017  Ι   April 2017


Harm Reduction Instead of Criminalization

This section comes from the Human Rights Education Project Toolkit, a resource that focuses on the right to health and the right of all British Columbians who use drugs to be free from the harmful effects of discrimination. Sections include the guiding principles of human rights for people who use drugs, community engagement and advocacy with people who use drugs, and resources for community action.

2020 (July) The Canadian Association of Chiefs of Police (CACP) announced that the association is recommending that all police agencies in Canada recognize substance abuse and addiction as a public health issue to help reduce drug overdoses and is endorsing the decriminalization of personal possession of illicit drugs. Findings and recommendations report: Decriminalization for Simple Possession of Illicit Drugs: Exploring Impacts on Public Safety & Policing

 

2020 (March) Clinical Guidance Risk Mitigation in the Context of Dual Public Health Emergencies
This guidance aims to support individuals who may be at increased risk of overdose, withdrawal, craving, and other harms related to their substance use. As the effects of the [COVID-19] pandemic continue, the drug supply may become significantly more adulterated and toxic, based on limited importation and availability, and illicit substances may become significantly more difficult to procure. (BC Centre on Substance Use). More resources on harm reduction and COVID-19

 

2019 (August) Pivot Legal Society releases the position paper Practical Drug Decriminalization in British Columbia. “While the possession of illicit drugs for personal use (“simple possession”) is a criminal offence, individual provinces still have significant powers to redress some of the harms of drug prohibition.In light of the federal government’s failure to meaningfully reform drug policy, provinces like B.C.can and must take legal steps to effectively (“de facto”) decriminalize simple possession by re-directing police resources away from its criminal enforcement.”

 

2019 (August) The Nurses and Nurse Practitioners of British Columbia (NNPBC) and the Harm Reduction Nurses Association (HRNA) call for the decriminalization of people who use drugs in BC. “As nurses who work in B.C. and provide frontline care in the midst of this public health emergency, we see firsthand the impact of criminalization on our clients, on their families, on our practice and our communities.”

 

2019 (July) Vancouver Coastal Health Chief Medical Health Office Dr. Patricia Daly releases
Response to the Opioid Overdose Crisis in Vancouver Coastal Health. Among other recommendations, Dr. Daly calls for decriminalization of personal possession of illegal drugs. “It is an acknowledgement that psychoactive substances, including opioids, will continue to be used by people for a variety of reasons, and the illegal nature of these substances is the primary risk factor for overdose death” (p. 29).

 

2019 (April) The Office of the Provincial Health Officer releases Stopping the Harm: Decriminalization of People Who Use Drugs in BC. In presenting the report, Provincial Health Officer Dr. Bonnie Henry cites two provincial mechanisms that could allow for de facto decriminalization of personal drug use. The first would use the Police Act to allow the minister of public safety and solicitor general to set broad provincial priorities with respect to people who use drugs (Stopping the Harm, p. 5). The second option, which also would use the Police Act, would add a provision preventing any member of a police force in BC from using resources for enforcement of simple possession offences (Stopping the Harm, p. 38).

 

Overdose Prevention, Care and Recovery

Interactive map of supervised consumption and overdose prevention sites courtesy of Pivot Legal Society

Toward the Heart: This website was developed by the Provincial Harm Reduction program. It provides Naloxone information (and other drugs), training, and information on becoming a Take Home Naloxone site.

Find Take Home Naloxone kits in your area:

List of overdose prevention sites in BC

Fentanyl safety for first responders

How to Use Naloxone (3-minute video)

Take Home Naloxone Training Manual 

Overdose Prevention Site Manual (Vancouver Coastal Health)

First Nations Health Authority Overdose Prevention Information

Guidelines and Resources for Supportive Housing Providers, Homeless Shelter Providers and Regional Health Authorities on Overdose Prevention and Response

 

Peer Voices and Resources

BC and Yukon Association of Drug War Survivors: BCYADWS is a drug user group based on advocacy, education and support.

Canadian Association of People Who Use Drugs is a group of people with lived experience of drug use; they emphasize the need for direct involvement of PWUD in policy making.

SANSU (Surrey Surrey Area Network of Substance Users Society) is an organization of current and former drug users in Surrey, BC that provides advocacy, harm reduction and social justice to people who use drugs in this region.

SOLID is a Victoria, BC-based organization of current or former drug users that provides support, education and advocacy.

VANDU: The Vancouver Area Network of Drug Users (VANDU) is a group of users and former users who work to improve the lives of people who use drugs through user-based peer support and education.

Patients Helping Patients Understand Opioid Substitution Treatment 

Peerology: A guide by and for people who use drugs on how to get involved in improving conditions for people who use drugs (PWUD).

The Opioid Chapters presents stories of 11 people living on the front lines of a constantly shifting opioid landscape in Ontario.

Engaging People Who Have Used Illicit Drugs in Qualitative Research

A Guide for Paying Peer Research Assistants – Challenges and Opportunities

From One Ally to Another – Practice Guidelines to Better Include People Who Use Drugs at Your Decision-Making Tables

 

Harm Reduction

The Harm Reduction Model of Drug Addiction Treatment TED talk with Dr. Mark Tyndall. This is a great piece on harm reduction that’s scientific, compassionate and realistic. (15 minutes)

Explaining Harm Reduction with Hardhats, Seatbelts, and Sunscreen: Two minute stick-figure animation explains harm reduction principles and benefits.

Indigenizing Harm Reduction: The First Nations Health Authority Indigenous Wellness team explores what harm reduction looks like from an Indigenous perspective, and how they facilitate dialogue with First Nations communities around the province. Scroll to bottom of page for video and slides.

What is Harm Reduction?  This explains the set of strategies and philosophies about reducing harm related to drug use and building a community of respect and support for people who use drugs.

Drug Checking as a Harm Reduction Intervention – Evidence Review Report (BC Centre on Substance Use, 2017)

Harm Reduction Saves Lives (Report, 2017)

Canadian Harm Reduction Network: “virtual meeting place for individuals and organizations dedicated to reducing the social, health and economic harms associated with drugs and drug policies.”

Harm Reduction International: “working to reduce the negative health, social and human rights impacts of drug use and drug policy by promoting evidence-based public health policies and practices, and human rights based approaches to drugs.”

 

Grief, Loss, and Developing Resilience in Overdose Care

Creating Cultures of Wellness: This video series with Vikki Reynolds can be viewed in separate parts or altogether to help teams build resilence and rediscover their strengths.

Take home Naloxone: A Guide to Promote Staff Resiliency and Prevent Distress After an Overdose Reversal.

Fentanyl Grief and Loss Support Group at Downtown Eastside Neighbourhood House in Vancouver. Sundays 6PM-8 PM (February 2017- )

Psychological First Aid: Guide for Field Workers:  This resource from the World Health Organization explains a framework for supporting people in ethical ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support.

Holding on with Letting Go – Vikki Reyolds

“Leaning In” as Imperfect Allies in Community Work – Vikki Reynolds

Resisting Burnout  – Vikki Reynolds

Explore more of Vikki Reynold’s Writing page

Opioid crisis workers are turning to AIDS epidemic veterans for help

 

The Fight Against Stigma

 

Stigma, Drug Addiction and Treatment Utilisation: PWUD Perspective (2016)

The World Drug Perception Problem: Countering Prejudices About People who Use Drugs (2017)

The Stigma Of Addiction Is More Dangerous Than Drug Overdoses

Language Matters: Reduce Stigma, Combat Overdose

Why We Should Say Someone Is A ‘Person With An Addiction,’ Not An Addict (2017)

A single paragraph published nearly 40 years ago contributed to the opioid epidemic (2017)

Science is the way out of the opioid overdose epidemic. Not stigma (2017)

How the Stigma of Drug Addiction Hurts All of Us (2017)

Northern Health’s Stop Stigma videos

The World Drug Perception Problem: Countering Prejudices About People who Use Drugs

 

Treatment Resources and Care

HealthLink BC provides free, non-emergency information including substance use or mental health. Alternate is a call to 811.

“Working Together to Reduce Harm” is the motto of the Toward the Heart site from the provincial harm reduction program includes information on finding overdose prevention sites, what different drugs do, support for people who use drugs and how to report bad dope.

 

Reports, Recommendations, Research

 

Statistical Reports on Overdose Deaths in BC 

Overdose Prevention and Response in BC (BC Government site)

The BC Centre for Disease Control provides Overdose Response Reports that include coroners reports and maps showing overdose response from first responders.

 

Provincial Government Reports

April 2019: Stopping the Harm: Decriminalization of people who use drugs in BC

May 2018: Responding to B.C.’s Illegal Drug Overdose Epidemic. Progress Update

June 2017: Letter to Parents and Guardians on talking to youth about drug use

May 2017: Fifth Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

April 2017: BC’s Opioid Overdose Response One-Year Update

March 2017  Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency  

January 2017 Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

November 2016 Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency

September 2016 Progress Update on B.C.’s Response to the Opioid Overdose Public Health Emergency 

In July of 2016 the BC government formed a Joint Task Force on Overdose Response. Regular progress reports outline action on BC’s public health emergency, identifying achievements to date and next steps underway. The provincial government maintains a page on the Overdose response which includes reports from the Task Force (below) and also offers Guidelines and Resources for Supportive Housing Providers, Homeless Shelter Providers and Regional Health Authorities on Overdose Prevention and Response.

Community Recommendations and Reports

Findings and Analysis for Overdose Prevention Society Data for Good Vancouver, 2018

Close to Home: Families & Caregivers Set priorities for addressing substance use addiction in BC BC Centre on Substance Use, April 2018

BC Overdose Action Exchange II Report BC Centre for Disease Control, August 2017

Overdose Data and First Nations in BC, First Nations Health Authority, July 2017

The Opioid Crisis: The Need for Treatment on Demand  Vancouver Police Department, May 2017

Recommendations of the Mayors’ Task Force on the Opioid Crisis May 2017

The Overdose Crisis – Where To Next? AIDS Vancouver Island, 2017

 

Drug Dependence and Substance Use Disorder

What is addiction, drug dependence, or substance use disorder? Here it is in brief from the Canadian Society of Addiction Medicine and the longer explanation from the American Psychiatric Association.

Drug Dependence Treatment and Care- Fundamental presentations from the Canadian Society of Addictions Medicine (2016)

Questions And Answers About Opioids And Chronic Pain

Commonly used illicit drugs (in general) and fentanyl specifically.

Frequently Asked Questions About Withdrawal

Frequently Asked Questions About Addiction 

 

Treatment and Research on Drug Use

A Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder – recommendations (2019)

A Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder – full document (2019)

Illicit Drug Poisonings: Is Decriminalization, Legalization, & Regulation the Answer? 

Revised Safe Prescribing of Opioids and Sedatives practice standard published (2018)

Guidelines for Clinical Management of Opioid Use Disorder BC’s provincial guidelines (2017)

Treatment guidelines to support pregnant women with opioid addiction

Management of opioid use disorders: a national clinical practice guideline

Center for Addictions Research of BC

British Columbia Centre on Substance Use 

Canadian Society of Addiction Medicine

 

Policy, Reporting and Advocacy

The Opioid Crisis in North America (2017)

Responding to the Overdose Crisis in British Columbia: A Rapid Assessment of Frontline/ Community-Based Organizations’ Capacity-and-Skills-Building Needs  (PAN, 2017)

Canadian Drug Policy, Supervised Consumption Sites & Provincial Response to the Public Health Crisis of Overdose Deaths (PAN, 2016)

Opioid epidemic causing rise in hepatitis C infections and other serious illnesses (2017)

World Drug Report 2017

Harm Reduction Saves Lives (2017)

The Good Samaritan Drug Overdose Act – what you need to know (2017)

Canadian Drug Policy Coalition works to support the development of a Canadian drug policy that’s science-based, guided by public health principles, and respectful of human rights. The CDPC’s work includes the involvement of people who use drugs.

The work of the Canadian HIV/AIDS Legal Network includes a commitment to reducing the harms associated with drugs and the harms caused by harsh, misguided drug laws.

International Doctors for Drug Policies The aims of this international group are to protect society and individuals from drug-related death and disease; put the health of people first; improve access to essential medicines, and expand access to evidence-based treatment.

Drug Policy Alliance: US-based non-governmental organization promoting drug policies that are grounded in science, compassion, health and human rights.

 

Image: Focus by Andrew, Flickr (Creative Commons)