By Scott Elliott

This week, Health Canada announced that the Dr. Peter AIDS Foundation is taking part in a new project examining the role integrated health care settings can play in fighting severe opioid addiction.

A $2.6-million project, Overcoming Barriers to iOAT (intravenous opioid agonist therapy): An Implementation Evaluation of iOAT in an Integrated Health Care Facility for Health Service Organizations Across Canada, is now underway in Vancouver at the Dr. Peter Centre. The centre has been providing a community of care in an integrated holistic and stigma-free environment for more than 20 years for those living with HIV.

This announcement arrives at a pivotal time—bookended by last week’s National Day of Action on the Overdose Crisis calling for a safe drug supply and the Harm Reduction International Conference, which I will be presenting at next week in Portugal, the epicentre of progressive responses to addiction of all kinds.

The overdose crisis respects no boundaries. It’s a problem in pockets throughout this city, and I know it’s a problem for my colleagues across the country—whether in Red Deer or Halifax. Severe addiction is a North American health problem. It’s a global health problem.

In Vancouver it isn’t isolated to the Downtown Eastside. It’s a problem in many neighbourhoods and the West End is no exception. In 2017, our centre experienced more deaths due to the opioid crisis than it did at the height of the AIDS epidemic.

At the Dr. Peter Centre we don’t see drug use, we see a health issue. And for the vast majority of our clients, substance use is made all the more complex by co-occurring medical issues. As well as HIV, many of our clients have hepatitis C, a diagnosed mental illness, history of trauma, and are experiencing mild to moderate cognitive impairment, compounded by poverty and episodes of homelessness.

Our integrated approach means that we work collaboratively with our clients to be actively engaged in their health care. 

With the implementation of iOAT at the Dr. Peter Centre comes access to an evidence-based medical therapy. Over the next two years this program will be made available to 25 clients. We’ll be able to monitor their experiences, and equally important, learn what works for them and what doesn’t.

Providing the drug alone is only part of the package. Our commitment to removing barriers and reducing the burden of access mean these clients will also have be able to use all of our services—quality food to keep them healthy, counselling services, life skills, music, recreation, and art therapy. 

This makes up the medical and therapeutic implementation, which will be then be evaluated.

What difference will this make? Our client-centred support promotes self-care through stabilization and engagement in their own health care leading to improved overall health. We see that this leads to more emergency room services and hospital beds available for others.

This program is one answer. The truth is this is a complex issue and no one knows the best route to get out of this crisis. We are all grappling, and there isn’t only one path. We need a comprehensive approach of harm reduction, medical intervention and treatment options.

This project gives us a chance to see what a difference intravenous opioid agonist therapy can make in our unique therapeutic environment, and to share the key learnings with other agencies across the country. 

We know the difference a stigma-free environment makes for those with HIV. We know the difference it makes for those who use our supervised injection service, which was the first located in an integrated health care setting in North America.

We know that when we open our doors to all those desiring care, in an environment that provides medical care without inducing or retriggering traumas, there is a greater chance of health, and if not full health, then certainly less pain, and fewer deaths.

We’ve got nothing to lose, and everything to gain.