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The National Safer Supply Community of Practice is conducting a survey to gather information from people living in Canada currently on OAT and/or safer supply about their experiences with take-home doses (aka: carries) and urine drug screenings. It is critical that the experiences and perspectives of people accessing safer supply and OAT in Canada are included in this project. Your responses will help us draft a series of recommendations for clinical guidance for health care providers regarding take-home doses and urine drug screenings.
The survey should take roughly 10–15 minutes and is completely confidential!
Access the survey here: https://forms.gle/NQSkwK32MWESogMB9
Complete our survey by Friday, March 31, 2023, and enter your email address at the end of the survey for a chance to win 1 of 5 prizes ($50 value each!). Please note: The prize draw is limited to people living in Canada.
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NSS-CoP Resource Library: Did you know we have a resource library with OVER 900 resources on safer supply? You can access it for FREE anytime. It features academic journal articles, grey literature, knowledge translation materials, clinical practice guidelines, and more!
Prescribed Safer Supply Protocols - Fentanyl Patch: These resources provide a standardized protocol for the provision of fentanyl patches to reduce reliance on the illicit drug supply and associated harms. This protocol is adapted from PHS Community Services Society’s Fentanyl Patch Policy and Vancouver Coastal Health’s Fentanyl Patch Clinical Operational Manual.
Love in the Time of Fentanyl: A group of misfits, artists, and drug users operates a renegade safe injection site in Vancouver’s Downtown Eastside. Love in the Time of Fentanyl is an intimate portrait of a community fighting to save lives and keep hope alive in a neighborhood ravaged by the overdose crisis. Click here to find a screening near you!
Crackdown Podcast - Episode 36: Some Exceptions Apply: A new episode of Crackdown Podcast is now available! Here's a brief description of the episode: "BC just decriminalized drugs. Well sort of. For the next three years, it’s legal to carry 2.5 grams or less of certain illicit drugs. But some exceptions apply. We’ve been fighting for decrim for decades. The goal has always been to stop arrests and get cops out of our lives. We got a watered down version of what we wanted. But the fact that the government did anything at all is because of our long struggle. And that struggle is far from over. Today we dig into the details of British Columbia’s diet decrim, the policy, the punditry, and the backlash. We also talk about what this reform means for the drug user liberation movement and where we go next."
Organizational Assessment Tool For Substance Use and Stigma: This tool was developed in partnership with CASPSA to help organizations identify policies, along with environmental and cultural factors that contribute to substance use stigma and discrimination. It can assist organizations in developing strategies for reducing stigma to create safer, more supportive environments and build policies and practices that are supportive and inclusive for staff, volunteers, and individuals seeking care.
HIV self-tests are here! Now what? In August 2022, the Government of Canada announced new funding to purchase and distribute HIV self-test kits across the country. The kits are being distributed to individuals and communities most affected by HIV through a combination of community-based organizations and mail orders placed online. CATIE and REACH Nexus - Community Link are collaborating to distribute HIV self-test kits to organizations that support the health of people who use substances. We, alongside many other groups, are working together to engage interested community-based organizations and services, and ensure that they receive kits, training, logistical support and information resources. How your organization can participate: Organizations that would like to learn more or sign up are encouraged to contact Ayibatonye Oriakhi at aoriakhi@catie.ca. We can give you more information and ensure you have access to appropriate quantities, training and support, and receive information resources to distribute with your self-test kits. To learn more about HIV self-testing, visit the CATIE website.
National Drug Alert System - Accidental Drug Poisoning Crisis Community of Practice: Using a crowdsourcing approach, the ADPC-CoP works with harm reduction services and drug-checking services from across the country to source accurate and up-to-date information regarding contaminated drug supply. This map-based dashboard displays contaminated drug supply alerts from their partner organizations. Please click on the User Guide at the bottom of the dashboard for more information on how to use the map.
Strengthening Public Health Systems in Canada: The Canadian Public Health Association has launched an advocacy campaign calling for governments across Canada to strengthen the foundations of public health systems, making them cohesive, comprehensive and accountable. In 2023, CPHA will ask federal Parliamentarians and officials to address the structure of public health systems as a highest-priority issue. Subsequently, we will address our campaign to provincial, territorial, regional and municipal governments as well. Learn more about the campaign here.
Webinar series on anti-Black racism and public health, Part 1: #BlackLivesMatter in public health: Critical race theory, historical roots and legacies of anti-Black racism: Part 1 discusses the roots and legacy of anti-Black racism in society and the field of health. It further explores concepts of whiteness and privilege to situate systems of inequity.
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RESEARCH PAPER OF THE MONTH
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Oviedo-Joekes, E., et al. (2023). “I can’t see anything but upside”: A qualitative study of clients’ experiences on North America’s first take-home injectable opioid agonist treatment (iOAT) program | Substance Abuse Treatment, Prevention, and Policy Preprint
Highlights:
- Participants reported that take-home doses granted them the freedom away from the clinic to have daily routines, form plans, and enjoy unstructured time. Participants appreciated the greater privacy, accessibility, and ability to engage in paid work. Furthermore, participants enjoyed greater autonomy to manage their medication and level of engagement with the clinic. These factors contributed to greater quality of life and continuity of care.
- Participants shared that their dose was too essential to divert and that they felt safe transporting and administering their medication off-site. In the future, participants would like to access longer take-home prescriptions, the ability to pick-up at different and convenient community pharmacies, and a medication delivery service.
- Reducing the number of daily onsite injections from two or three to only one revealed the diversity of rich and nuanced needs that added flexibility and accessibility in iOAT can meet.
- Urgent action such as policy reform and licensing diverse opioid medications/formulations is necessary to make these measures permanent and meet the varied needs and preferences of OUD clients.
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We encourage NSS-CoP members to email info@nss-aps.ca with submissions to include in our newsletter. Content examples include but are not limited to community-led projects, peer-reviewed articles, grey literature, government publications, etc.
- Argento, E., et al. (2023). Increasing trends and incidence of nonfatal overdose among women sex workers who use drugs in British Columbia: The role of criminalization-related barriers to harm reduction | Drug and Alcohol Dependence
- Crépault, J.-F., et al. (2023). What is a public health approach to substance use? A qualitative systematic review and thematic synthesis | International Journal of Drug Policy
- Brothers, T., et al. (2022). Uptake of slow-release oral morphine as opioid agonist treatment among hospitalised patients with opioid use disorder | Drug and Alcohol Review
- Perreault, M., et al. (2023). Implementation facilitators and barriers to the expansion of a peer-led overdose prevention program | Drugs: Education, Prevention and Policy
- Myran, D. T., et al. (2023). Changes in mortality for the general population and individuals with pre-pandemic acute care for alcohol or opioids during the COVID-19 pandemic in Ontario, Canada | Canadian Journal of Psychiatry
- Chang, J. (2023). Rigid opiate agonist treatment programmes risk denying people their agency | BMJ
- Van Draanen, J., et al. (2023). Pathways connecting socioeconomic marginalization and overdose: A qualitative narrative synthesis | International Journal of Drug Policy
- Parent, S., et al. (2023). Original quantitative research – Opioid-related deaths in Kingston, Frontenac, Lennox and Addington in Ontario, Canada: the shadow epidemic | Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice
- Thompson, T., et al. (2023). Original qualitative research – Exploring the contextual risk factors and characteristics of individuals who died from the acute toxic effects of opioids and other illegal substances: listening to the coroner and medical examiner voice | Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice
- Van Santen, D. K., et al. (2023). Comprehensive needle and syringe program and opioid agonist therapy reduce HIV and hepatitis c virus acquisition among people who inject drugs in different settings: a pooled analysis of emulated trials | Addiction
- Ghafri, Q. A., et al. (2023). Barriers and Facilitators to Accessing Inpatient and Community Substance Use Treatment and Harm Reduction Services for People Who Use Drugs in the Muslim Communities: A Systematic Narrative Review of Studies on the Experiences of People Who Receive Services and Service Providers | Drug and Alcohol Dependence
- Cates, L., et al. (2023). Medications for opioid use disorder during incarceration and post-release outcomes | Health & Justice
- Magel, T., et al. (2023). How injectable opioid agonist treatment (iOAT) care could be improved? service providers and stakeholders’ perspectives | Drugs: Education, Prevention and Policy
- Hervera, B., et al. (2023). Implementation of an integrated infectious disease and substance use disorder team for injection drug use-associated infections: a qualitative study | Addiction Science & Clinical Practice
- Thakrar, A. P., et al. (2023). Safety and preliminary outcomes of short-acting opioid agonist treatment (sOAT) for hospitalized patients with opioid use disorder | Addiction Science & Clinical Practice
- Magnan, E. M., et al. (2023). Association Between Opioid Tapering and Subsequent Health Care Use, Medication Adherence, and Chronic Condition Control | JAMA Network Pharmacy and Clinical Pharmacology
- Nosyk, B., et al. (2023). Incremental expenditures attributable to daily dispensation and witnessed ingestion for opioid agonist treatment in British Columbia: 2014-2020 | Addiction
- Monarque, M., et al. (2023). Digital interventions for substance use disorders in young people: rapid review | Substance Abuse Treatment, Prevention, and Policy
- Hooker, S. A., et al. (2023). A randomized controlled trial of an intervention to reduce stigma toward people with opioid use disorder among primary care clinicians | Addiction Science & Clinical Practice
- Raphael, D., et al. (2023). Socialism as the way forward: updating a discourse analysis of the social determinants of health | Critical Public Health
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COMMUNITY UPDATES & EVENTS
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The OPTIMA Trial: Optimizing Flexible Models of Care for OUD in Ontario: Hosted by CRISM in collaboration with the CRISM Ontario node, this roundtable webinar on March 2nd at 11:30am EST aims to regroup clinicians in a discussion on the implementation and expansion of flexible models of care for the clinical management and treatment of prescription opioid use disorder. In this session, we will hear from OPTIMA clinician Dr. Nikki Bozinoff and a multidisciplinary group of expert including physicians Dr. Wiplove Lamba, Dr. Claire Bodkin, nurse practitioner Mae Katt and pharmacist Mark Barnes. After outlining the findings of the national OPTIMA trial, which ran from 2017-2020, this multidisciplinary panel of clinicians will discuss some of the key considerations, barriers, benefits, and experiences around the practice and prescription of take-home doses of OAT, such as with BUP/NAL, in the context of Ontario. Through this discussion, the panel will explore next steps on how to optimize and expand flexible models of care and patient-clinician shared decision-making for OAT in clinical practice.
Making the case for shared decision making in OUD care - A national case-based discussion with Community & Clinical experts: Join CRISM on March 9th from 1:00-2:30pm EST as they bring together an interdisciplinary group of substance use experts to work through a clinical case for Opioid Use Disorder care. In this hour and a half webinar, clinicians and community experts will explore, debate, and collaborate on ways to meet both the patient’s and provider’s concerns for shared decision making in OUD care and treatment. Led by two accomplished moderators Natasha Tousenard and Emma Garrod, the group of community subject experts Matthew Bonn, Iye Sanneh, and Frank Crichlow, and clinicians Jac Atkinson, Dr. Monty Ghosh, and Dr. Alana Hirsh, will discuss how to best approach and enhance a patient’s treatment and overall management of opioid use disorder by highlighting flexibility and person-centered approaches to care.
SJA Opioid Poisoning Response Training Program - Vancouver Summit Virtual Attendee Link: Join the SJA Opioid Poisoning Response team live on Thursday, March 23rd, 2023 for a day of learning, listening, and community building. Hear from three wonderful speakers local to Vancouver as they tell us about their wins, losses, and how to strengthen community. This link is to join virtually only. If you wish to join them in-person, please register here.
Webinar Series on Anti-Black Racism and Public Health - National Collaborating Centre for Determinants of Health: Anti-Black racism is a specific form of racism, rooted in the colonial history and practice of enslavement, that continues to impact the lives of Black people, regardless of whether they have a specific lineage to the enslaved in Canada, or if they are recent comers to Canada. Policies and practices rooted in Canadian institutions such as, health care, education, and justice mirror and reinforce beliefs, attitudes, prejudice, stereotyping and/or discrimination towards people of African descent and lead to a lack of equitable access, opportunities, and outcomes for Black people. In this series, participants will explore how anti-Black racism impacts health and identify concrete opportunities for public health action. Learn more about the series here!
Public Health 2023 - Canadian Public Health Association: Public Health 2023 is the national conference where public health professionals, researchers, policy-makers, academics, students, and trainees come together to strengthen efforts to improve health and well-being, to share the latest research and information, to promote best practices and to advocate for public health issues and policies grounded in research. CPHA will embrace technology and present sessions June 20th to 22nd from 11am to 4:30pm EDT daily. Find more information and important dates here!
5th Annual British Columbia Substance Use Conference: The British Columbia Centre on Substance Use conference planning committee is excited to announce that the 5th annual BC Substance Use Conference will be held April 20th to 22nd, 2023. To enable provincial-wide participation, BCCSU will be hosting a blended conference this year, with both virtual and in-person options for attendance. The in-person program will be held at the JW Marriott Park Vancouver. The conference theme this year is The Challenge of Change. Abstract submissions are now open - the deadline is February 28th! Registration information coming soon - find more information here!
META:PHI Webinar Series 2023: Check out and register for the META:PHI webinar series line up for 2023. META:PHI hosts a virtual presentation on the second Wednesday of each month from 7:00pm to 8:30pm EST. These sessions are intended for service providers who work with people who use substances. All sessions are free.
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National and General News:
British Columbia:
Alberta:
Saskatchewan:
Manitoba:
Ontario:
Yukon, Northwest Territories, and Nunavut:
Québec (et en français s'il vous plaît!):
Atlantic Region (Nova Scotia, New Brunswick, Prince Edward Island, Newfoundland and Labrador):
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