ID: HR19-1293

Presenting author: Elizabeth Holliday

Presenting author biography:

Elizabeth Holliday, MSc, MPH is the Manager for HIV Prevention, Harm Reduction and Aboriginal Partnerships with Vancouver Coastal Health (VCH). She leads teams and programs responding to the Opioid Crisis in the VCH region. She has immense respect and gratitude for the peers on the front-line of the crisis response.

Vancouver Coastal Health's Overdose Emergency Response: Strategies for A Region in Crisis

Elizabeth Holliday, Sarah Levine, Rebecca Thomas, Shannon Riley, Sebastien Payan, Misty Bath, Helenka Jedrzejowski

Issue

Fentanyl contamination has resulted in an overdose emergency in Vancouver, Canada. In 2017, there were 436 overdose deaths in the region and as of June, 213 deaths (57.8 deaths per 100,000) in 2018

Setting

Vancouver Coastal Health (VCH) serves over a million people in Vancouver and surrounding communities, including the Downtown Eastside, where overdose rates are the highest in the province. The majority of overdose deaths were among males 19-59, and 88% of illicit drug overdose deaths occurred inside.

Project

The VCH Overdose Emergency Response (OER) aims to prevent overdose deaths and reduce harms associated with overdose through innovative strategies designed to:

• Support peer employment and empowerment
• Increase naloxone access and overdose education
• Support safe spaces to use substances
• Expand drug checking
• Provide overdose case management
• Improve access to oral and injectable Opioid Agonist Treatment

Partnerships with peer- and community-based organizations are essential to this strategy.

Outcomes

The OER has created and/or supported innovative services to build a continuum to support individuals at risk of overdose.

• VCH’s 6 Overdose Prevention Sites and 2 Supervised Consumption Sites receive ~30,000 visits a month, with no overdose deaths at any site.
• +4,400 people have been trained in naloxone and advanced overdose management.
• 279 peers have been trained in overdose prevention at a peer learning lab.
• VCH supports housing overdose prevention services at +54 sites.
• 1,359 people are receiving oral or injectable OAT.
• 2,432 people have been connected to addiction care by the Overdose Outreach Team.

Community and peer leadership is essential to the innovation and success of these interventions. However, health-based interventions constitute only a partial response. A comprehensive strategy requires a policy environment supportive of providing access to safe supply and reducing the stigma of using currently illegal drugs.