Substance Use News provides a monthly collection of news and resources on the social, medical and political responses to the toxic drug supply crisis and information about alcohol harm reduction. Please check Info for People Who Use Substances to get the latest alerts, and tips on how to stay safe from Toward the Heart. New to this work? Visit our Substance Use and Harm Reduction page for more resources.
In the News
189 people in BC died in October due to toxic drugs
It’s the 37th consecutive month with at least 150 deaths related to the crisis, province says. October’s numbers are consistent with the trends of the crisis. The majority of those who died were between 30 and 59 years of age and more than three-quarters were male. The largest number of deaths in 2023 so far have occurred in BC’s bigger cities such as Vancouver, Surrey and Victoria. But Northern Health has the highest rate of deaths, with 61 per 100,000 residents. (November 30, 2023)
BC Moves Ahead with a National Opioid Damages Lawsuit
Last year, British Columbia, on behalf of Canada, reached a settlement of $150 million with Purdue Pharma, the pharmaceutical company owned by the Sackler family that produced the highly addictive painkiller and opioid OxyContin. This was the largest-ever settlement of a government health claim in Canadian history, B.C. Attorney General Niki Sharma said on Monday. Downtown Eastside resident and community advocate Karen Ward is critical of the government’s decision to sue pharmaceutical companies. It is drug policy, not drugs, that is killing people, she said. The government could regulate substances and reduce deaths but is choosing not to, she added. (November 28. 2023)
‘Moms Stop the Harm’ Requests that the BC Government Investigate the Recovery Industry
An open letter to Attorney General Niki Sharma from Moms Stop the Harm asks for “an immediate investigation into the transfer of millions of public dollars from the provincial government to private recovery programs with little or no government oversight. We, as supporters of regulated, accessible substance use treatment and voluntary support programs, are alarmed that the provincial government continues to blindly fund an industry without addressing the countless allegations of abuse, sexual assault, and deaths of vulnerable clients that have been revealed at these programs.” (November 23, 2023)
BC Updates Its Opioid Use Disorder Treatment Guidelines
BC clinicians have newly updated clinical guidance to help deliver care for people living with opioid use disorder. The updated provincial Guideline for the Clinical Management of Opioid Use Disorder was published by the BC Centre on Substance Use (BCCSU) today. The updates provide clinicians with guidance to help people engage and stay on treatment, pursue recovery, and reduce their reliance on unregulated substances. They were developed in response to the ongoing and evolving drug poisoning crisis – in which the unregulated drug supply continues to intensify in toxicity – and reflect the latest in evidence, as well as clinical and patient experiences. (November 22, 2023)
Why DULF’s Founders Deserve Awards, Not Arrests
It is ironic to note that a week or so after the arrests of two members of the Drug User Liberation Front, the Chief Coroner’s latest report called for exactly what DULF was doing, but of course with legal substances. Why then is safe supply being eliminated with DULF in Vancouver? How does eliminating a source of tested, safer supply of illegal drugs serve those who are vulnerable to toxic drugs? (November 21, 2023)
‘DULF, as We Knew It, Is Dead’
On October 25, Vancouver police raided the homes and workplace of the Drug User Liberation Front, also known as DULF. DULF had been running a compassion club for just over a year at the time of the arrests. The idea was to give people access to a clean, regular supply of drugs to protect people from the toxicity of B.C.’s current illicit street drug supply. On November 1, the BC Coroners Service released a report that called for BC to move away from its prescription-based safer supply program and instead adopt a non-medical model distributed to eligible people through community-based programs. Minister of Mental Health and Addictions Jennifer Whiteside turned down the recommendation the same day. (November 10, 2023)
Cocaine use rising in Canada, new data suggests, as researchers link stimulants to drug deaths
More Canadians are using stimulants such as cocaine, new federal data suggests, and experts warn the trend is contributing to a high percentage of drug-related deaths. In most municipalities studied, cocaine levels rose from January to May 2022 compared with the same period in 2020, and early data for 2023 suggests that overall rise is continuing, according to a Statistics Canada report released on November 1, 2023.
An Urgent Response to a Continuing Crisis (BC Coroner Service Death Review Panel report)
The chief coroner convened a standing death review panel with a mandate to consider previous death review panel recommendations that could be quickly implemented on a scale that could meaningfully reduce substance related deaths in BC. The panel reaffirms the need for a comprehensive and timely approach to the crisis and recognizes that, in the short term, the fastest way to reduce deaths is to reduce dependence on the unregulated toxic drug supply for people who use drugs. This requires creating access to a quality controlled regulated supply of drugs for people at risk of dying. The urgent need for a practical, scalable response to the public health emergency requires pursuit of a non medical model that provides people who use drugs with an alternative to the unregulated drug market. (November 1, 2023)
Unregulated Drug Deaths in B.C. (to September 30, 2023)
British Columbia’s Coroner Service has released the latest statistics on unregulated drug deaths in the province. There were 175 suspected unregulated drug deaths in September 2023, a 10% decrease over the number of deaths in September 2022 (194) and a 2% decrease over the number of deaths in August 2023 (178). Smoking was the most common mode of consumption in 2023 with 65% showing evidence of smoking followed by injection (15%), nasal insufflation, (14%), and oral (4%). (Posted November 1, 2023.)
BC nurses will soon be able to prescribe opioid-use disorder medication
Registered nurses and registered psychiatric nurses in B.C. will soon be able to prescribe medication for opioid use disorder (OUD) in a move the province hopes will allow more people with addiction to seek help. The BC College of Nurses and Midwives (BCCNM) announced in September that it had created a new designation of certified practice, to allow RNs and RPNs to diagnose and treat substance use disorder after completing training from the BC Centre on Substance Use. (November 1, 2023)
Nurses Condemn the Arrests of Safe Supply Providers
As harm reduction nurses, we condemn the recent Vancouver Police Department arrests of Drug User Liberation Front organizers. DULF uses a compassion club model to openly distribute tested supplies of cocaine, heroin and methamphetamine for people’s personal use. As with other safe supply programs, DULF members have reported an improved quality of life alongside fewer experiences of overdose, hospitalization and drug-related violence, including negative interactions with police. This program offers a low-barrier, person-centred and impactful intervention that is mitigating overdose risk while contributing to broader improvements in health and social well-being. These gains should be not criminalized but celebrated, supported and evaluated through continued research. (October 31, 2023)
Advocacy and Research
Webinar: Examining Moral Distress in Health Care
This webinar is in partnership with Registered Nurses Association of Ontario, (RNAO), Harm Reduction Nurses Association, Mental Health Nursing Interest Group, Community Health Nurses’ Initiative Group, Moms Stop the Harm and the National Safer Supply Community of Practice. This webinar will provide participants with a deeper understanding regarding moral distress and to learn about the role of workplace psychosocial safety in creation of a supportive environment. December 12th, 10 AM Pacific time.
Library on the Frontlines
You wouldn’t expect to find an overdose response and prevention team at a library, but Edmonton’s flagship library is going next level to take care of some of its most vulnerable citizens. Listen to this story on the podcast White Coat Black Art.
INHSU 2023: Global lessons for the health of people who use drugs
In October, CATIE attended INHSU 2023, the 11th International Conference on Health and Hepatitis Care in Substance Users. This leading international conference brought together experts from around to discuss the latest in research, programs and policy on hepatitis and the health of people who use drugs. See video from CATIE asking presenters and attendees and asked them to share key messages from the conference.
Overdose prevention centres in New York don’t lead to more crime
In late November 2021, the first officially sanctioned US overdose prevention sites began operation in New York. When researchers compared syringe service programs in New York City with two programs that were recently sanctioned by city officials to offer supervised drug consumption, they found no significant increases in crimes recorded by the police or calls for emergency service in the surrounding neighborhoods.
Shame and stigma in association with the hepatitis C cascade to cure among people who inject drugs
Psycho-social experiences including shame and experienced and internalized stigma have been associated with substance use, hepatitis C (HCV or hep C) infection, and reluctance to disclose HCV status and pursue treatment. This research examines baseline relationships with HCV-stigma and engagement across the HCV treatment cascade as well as baseline and longitudinal relationships between shame and engagement across the HCV treatment cascade including treatment initiation, adherence, completion, and sustained virologic response (SVR) among a multi-site sample of people who inject drugs with HCV.
Stigma experienced by opioid-dependent moms affects baby’s health care
“Moms would just withdraw from even receiving health care in the first place in an effort to protect their child from being stigmatized, so they were less likely to take their baby to the pediatrician and less likely to take advantage of developmental services for their baby” said study lead Jamie Morton. This sometimes led to the mothers being referred to as “noncompliant” “bad mothers.”
Visit the BC Centre for Disease Control’s Unregulated Drug Poisoning Emergency Dashboard for provincial data from different sources.
Visit the BC Centre on Substance Use for information on evidence-based approaches to substance use care and harm reduction.
Visit the National Safer Supply Community of Practice (NSS-CoP), whose goal is to scale up safer supply programs across Canada.
Visit the Canadian Institute for Substance Use Research site for research on aclohol and substance use.
Questions? Feedback? Get in touch. Janet Madsen, Capacity Building and Digital Communications Coordinator, [email protected]
Focus image by Andrew, Flickr (Creative Commons)