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NSS-CoP Resource Library: Did you know we have a resource library with OVER 700 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!
Over-Medicalization: A Facilitated Discussion with Corey Ranger & Karen Ward - Harm Reduction Nurses Association: This is a recording of a facilitated conversation that discusses the harms associated with the medical co-option of harm reduction. Panellists Corey and Karen share what nurses need to know about the toxic drug poisoning emergency and how they can be effective advocates from the nursing perspective while avoiding performative allyship.
META:PHI - Generic Methadone Information Sheets: META:PHI recently undertook a very quick consultation process with community advisors to create two communication documents, intended for health care providers and for people on methadone. These documents reflect what they heard from health care providers (pharmacists, physicians, nurses, and nurse practitioners) and from people on/with experience of methadone about the important messages to be communicated. While both documents can be used by anyone, this information sheet is designed for people on methadone and this information sheet is designed for health care providers.
Questions and Answers for Pharmacies - Policy for Methadone Maintenance Treatment (MMT) Reimbursement under the Ontario Drug Benefit Program: Changes to Methadose formulations funded in Ontario came into effect on August 31st. Review the Methadone Maintenance Treatment Reimbursement 2022 Policy updates here and find more information.
Experiences of Harm Reduction Service Providers During Dual Public Health Emergencies in Canada - Canadian Centre on Substance Use and Addiction: This report examines the benefits and challenges harm reduction workers across Canada are facing as they continue to deal with the concurrent opioid-related toxicity emergency and COVID-19 pandemic.
Toolkit: Knowing How to Recognize and Respond to a Severe Intoxication or Overdose Related to Psychoactive Substance Use or Alcohol Withdrawal: The Équipe de soutien clinique et organisationnel en dépendance et itinérance has published a new toolkit! This toolkit is intended for frontline service providers who work with people who use psychoactive substances, who may or may not be specialized in the field of substance use, and who work in isolation wards, housing services for those who are homeless or street-involved, managed alcohol programs (wet services), drop-in services, emergency shelters and all other services that are frequented by people who use psychoactive substances. The toolkit includes infosheets that provide information on severe intoxications, overdoses and severe withdrawal (of alcohol only), the main signs and symptoms that can help us to recognize these states, and the actions to implement in order to prevent or to respond to them when they occur.
Community Urinalysis and Self-Report Project: Cross-Canada Report on the Use of Drugs from the Unregulated Supply, 2019-2021 Data - Canadian Centre on Substance Use and Addiction: Presents substance use trends and describes whether expected substance use matched actual substance contents. Data were collected from harm reduction sites in seven regions across Canada that participated in the Community Urinalysis and Self-Report Project between 2019 and 2021.
Ontario Opioid Indicator Tool - Ontario Drug Policy Research Network: The Ontario Opioid Indicator Tool provides public access to indicators of opioid use, opioid-related harms, and access to treatment and harm reduction in the province from 2012 onwards using data housed at ICES. Since the ODPRN’s initial launch of this tool in 2018, the landscape of the overdose crisis in Ontario has shifted, with an increasing recognition that the majority of opioid-related harms have been associated with the unregulated opioid supply, which is predominantly made up of fentanyl. To better meet the needs of the current crisis, the tool has been updated with new indicators which have an increased focus on opioids used for the treatment of opioid use disorder, as well as complications arising from opioid-related harms not reported elsewhere. This tool is designed to complement Public Health Ontario’s interactive tool on opioid-related morbidity and mortality in Ontario which includes similarly presented indicators of opioid-related emergency department visits, hospitalizations, and deaths.
Where To?: This new online directory is for people looking for HIV, hepatitis C, sexual health or harm reduction services in Canada, with additional resources to support their journey to health and wellness. The website allows you to search for services by location or by type of service. CATIE operates and maintains this website. Service providers can also register their own organization. An administrator will review your listing before it gets published.
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RESEARCH PAPER OF THE MONTH
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Gomes, T., Kolla, G., McCormack, D., Sereda, A., Kitchen, S., & Antoniou, T. (2022). Clinical outcomes and health care costs among people entering a safer opioid supply program in Ontario | Canadian Medical Association Journal
Highlights:
- Background: London InterCommunity Health Centre (LIHC) launched a safer opioid supply (SOS) program in 2016, where clients are prescribed pharmaceutical opioids and provided with comprehensive health and social supports. We sought to evaluate the impact of this program on health services utilization and health care costs.
- Methods: We conducted an interrupted time series analysis of London, Ontario, residents who received a diagnosis of opioid use disorder (OUD) and who entered the SOS program between January 2016 and March 2019, and a comparison group of individuals matched on demographic and clinical characteristics who were not exposed to the program.
- Results: In the time series analysis, rates of ED visits (−14 visits/100, 95% confidence interval [CI] −26 to −2; p = 0.02), hospital admissions (−5 admissions/100, 95% CI −9 to −2; p = 0.005) and health care costs not related to primary care or outpatient medications (−$922/person, 95% CI −$1577 to −$268; p = 0.008) declined significantly after entry into the SOS program (n = 82), with no significant change in rates of infections (−1.6 infections/100, 95% CI −4.0 to 0.8; p = 0.2).
- Interpretation: Although additional research is needed, this preliminary evidence indicates that SOS programs can play an important role in the expansion of treatment and harm-reduction options available to assist people who use drugs and who are at high risk of drug poisoning.
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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.
- McAnulty, C., et al. (2022). Buprenorphine/naloxone and methadone effectiveness for reducing craving in individuals with prescription opioid use disorder: Exploratory results from an open-label, pragmatic randomized controlled trial | Drug and Alcohol Dependence
- Nikoo, M., et al. (2022). Opium tincture versus methadone for opioid agonist treatment: a randomized controlled trial | Addiction
- Goodyear, K., et al. (2022). The impact of race, gender, and heroin use on opioid addiction stigma | Journal of Substance Abuse Treatment
- Cui, Z., et al. (2022). Predictors of Crystal Methamphetamine Use Initiation or Re-initiation among People receiving Opioid Agonist Therapy: A Prospective Cohort Study | Drug and Alcohol Dependence
- Ellerbroek, H., et al. (2022). Buprenorphine/naloxone versus methadone opioid rotation in patients with prescription opioid use disorder and chronic pain: study protocol for a randomized controlled trial | Addiction Science & Clinical Practice
- Gehring, N. D., et al. (2022). Social service providers’ perspectives on caring for structurally vulnerable hospital patients who use drugs: a qualitative study | BMC Health Services Research
- Karamouzian, M., et al. (2022). Shifts in substance use patterns among a cohort of people who use opioids after delisting of OxyContin in BC, Canada: An interrupted time series study | International Journal of Drug Policy
- Barrett, D., et al. (2022). Child-centred harm reduction | International Journal of Drug Policy
- Fitzpatrick, T., et al. (2022). Heroin pipe distribution to reduce high-risk drug consumption behaviors among people who use heroin: a pilot quasi-experimental study | Harm Reduction Journal
- Murray, S., et al. (2022). Caring for People Who Use Drugs: Best Practices for EMS Providers | Health Promotion Practice
- Williams, A. R. (2022). MOUD saves lives, especially after 60 days, and the longer the better | Addiction
- Picco, L., et al. (2022). How do patient, pharmacist and medication characteristics and prescription drug monitoring program alerts influence pharmacists' decisions to dispense opioids? A randomised controlled factorial experiment | International Journal of Drug Policy
- Bosse, J. D., et al. (2022). Patient evaluation of a smartphone application for telehealth care of opioid use disorder | Addiction Science & Clinical Practice
- David, A. R., et al. (2022). Barriers to accessing treatment for substance use after inpatient managed withdrawal (Detox): A qualitative study | Journal of Substance Abuse Treatment
- Ledberg, A. & Reitan, T. (2022). Increased risk of death immediately after discharge from compulsory care for substance abuse | Drug and Alcohol Dependence
- Francia, L., et al. (2022). “The peer workers, they get it” – how lived experience expertise strengthens therapeutic alliances and alcohol and other drug treatment-seeking in the hospital setting | Addiction Research & Theory
- Tardelli, V. S., et al. (2022). Marked Increase in Amphetamine-Related Emergency Department Visits and Inpatient Admissions in Toronto, Canada, 2014–2021 | Canadian Journal of Psychiatry
- Chung Tse, W., et al. (2022). Modeling the cost and impact of injectable opioid agonist therapy on overdose and overdose deaths | Journal of Substance Abuse Treatment
- Donaldson, S. R., et al. (2022). Transformation of identity in substance use as a pathway to recovery and the potential of treatment for hepatitis C: A systematic review | Addiction
- Lugoboni, F., et al. (2022). COVID-19 vaccination and drug users: Past, present, and future | Journal of Public Health Research
- Roux, P., et al. (2022). Impact of drug consumption rooms on non-fatal overdoses, abscesses and emergency department visits in people who inject drugs in France: results from the COSINUS cohort | International Journal of Epidemiology
- Hochstatter, K. R., et al. (2022). Characteristics and correlates of fentanyl preferences among people with opioid use disorder | Drug and Alcohol Dependence
- Gottschalk, M. (2022). The Opioid Crisis: The War on Drugs Is Over. Long Live the War on Drugs | Annual Review of Criminology
- Stevens, A. (2022). New prospects for harm reduction in the UK? A commentary on the new UK drug strategy | International Journal of Drug Policy
- Stotts, A. L., et al. (2022). Facilitating treatment initiation and reproductive care postpartum to prevent substance-exposed pregnancies: A randomized bayesian pilot trial | Drug and Alcohol Dependence
- Mutschler, C., et al. (2022). Developing a realist theory of community-based residential substance use treatment | Drugs: Education, Prevention, and Policy
- Ware, O. D., et al. (2022). The association of chronic pain and opioid withdrawal in men and women with opioid use disorder | Drug and Alcohol Dependence
- Gentile, V., et al. (2022). Much being Written about Us, not much being Written with Us: Examining how alcohol and other drug use by indigenous Australians is portrayed in Australian Government policies and strategies: A discourse analysis | International Journal of Drug Policy
- Mercer, F., et al. (2022). Patient, family members and community pharmacists' views of a proposed overdose prevention intervention delivered in community pharmacies for patients prescribed high-strength opioids for chronic non-cancer pain: An explorative intervention development study | Drug and Alcohol Review
- Nolan, S., et al. (2022). Harm reduction in the hospital: An overdose prevention site (OPS) at a Canadian hospital | Science Direct
- Pijl, E. M., et al. (2022). Barriers and facilitators to opioid agonist therapy in rural and remote communities in Canada: an integrative review | Substance Abuse Treatment, Prevention, and Policy
- Russell, C., et al. (2022). Opioid agonist treatment take-home doses (‘carries’): Are current guidelines resulting in low treatment coverage among high-risk populations in Canada and the USA? | Harm Reduction Journal
- Francia, L., et al. (2022). Putting out the welcome mat—A qualitative exploration of service delivery processes and procedures as barriers to treatment-seeking for people who use alcohol and other drugs | Drug and Alcohol Review
- Bozinoff, N., et al. (2022). Prescribing Characteristics Associated With Opioid Overdose Following Buprenorphine Taper | JAMA Network Open
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COMMUNITY UPDATES & EVENTS
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Saving Our Own Lives - A Liberatory Practice of Harm Reduction: Join this exciting conversation hosted by Haymarket Books on Wednesday, October 5th at 6:30pm EDT. The conversation will be about liberatory harm reduction, featuring Shira Hassan and other organizers, and about her new book, Saving Our Own Lives. Register now!
Sudden Silence - Hidden Voices: This project is an adaptation of a photo voice project funded through a Vancouver Community Action Grant. The purpose of this project is to highlight the tragedy of the overdose crisis and introduce some of those who have been lost. Their loss is most keenly felt through their loved ones. Their grief cannot be described in words and is their constant companion. This project also focuses on the impact of the stigma for using drugs and of how safe supply might have made a difference.
Registration for the 2022 Manitoba Harm Reduction Conference is now OPEN! In collaboration with Ka Ni Kanichihk and the Winnipeg Regional Health Authority, the Manitoba Harm Reduction Network (MHRN) is hosting the 2022 Manitoba Harm Reduction Conference in Winnipeg from November 15th to 17th. This conference is a three-day event that will feature speakers from throughout Manitoba, Canada, and the United States as they share on a variety of topics related to harm reduction and sexual health. With a strong focus on Indigenous knowledge, anti-oppression, and root causes of harms related to substance use, MHRN aims to inspire conference participants to improve access to harm reduction services throughout Manitoba especially in rural, remote, northern, and Indigenous communities. Click here for more information and to register.
BC ECHO on Substance Use Project Webinar: Buprenorphine/Naloxone Induction Approaches with Dr. Leslie Lappalainen on Thursday, October 27th from 12-1pm PDT | 3-4pm EDT. By the end of this BC ECHO on Substance Use session, participants will be able to: 1) describe the pharmacodynamics and pharmacokinetics of buprenorphine/naloxone, 2) use the clinical opioid withdrawal scale (COWS) and subjective opiate withdrawal scale (SOWS) to assess opioid withdrawal, 3) describe when micro-dosing inductions and traditional inductions are most appropriate, and 4) describe how to conduct a buprenorphine/naloxone induction. Register now!
Primary Care of Ontario Research and Learning (POPLAR): Attention primary care clinicians working in Fee-for-Service (FFS) models in Ontario! The Primary Care of Ontario Research and Learning (POPLAR) network is looking for guidance as we expand our outreach to FFS practitioners. We know it’s especially challenging for busy clinicians, especially those working without the support of an interprofessional team, to find time for networking, research, and knowledge-sharing. We also know that some feel reluctant to share their practice-based data with larger networks. We’d love to hear from you about what barriers you or your colleagues may be experiencing and what value you would need to get from a learning and research network in order to make participation worthwhile. Read more about POPLAR here. For more information or to share your ideas, please contact Catherine.Macdonald@AllianceON.org or info@poplarnetwork.ca.
CRISM is seeking public input on a draft of Canadian Take-Home Naloxone Guidance through two channels:
1) Online Survey: An online survey that is open to anyone living in Canada. This link leads you to a survey with a PDF of the report. Anyone who completes the survey has the option of entering a draw to win one of two $100 visa cards.
2) Consultation Sessions: Consultation sessions are open to anyone with lived or living experience of using drugs and/or experience responding to overdose in the community. The consultation sessions last 90 minutes where we explain our process and conclusions and ask whether there is information that we might not have considered, whether those recommendations would work in their context, and whether there are any barriers that folks might encounter. There is a $50 honorarium for participation. Contact take.home.naloxone.guideline@gmail.com if interested.
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National and General News:
British Columbia:
- Thousands in B.C. will continue to die until there is a safe drug supply, say advocates
- Remembering a Downtown Eastside Warrior
- Vancouver club will continue to distribute hard drugs in bid to save lives, despite Health Canada rejection
- Drug user compassion groups in B.C. see success in safe supply distribution
- Health Canada Denies Compassion Club Exemption for Safe Supply
- Vancouver’s Unconventional Approach to Its Fentanyl Crisis
- Interior Health's slow progress on safe supply frustrates doctor, advocates
- Addiction is a symptom of colonization — advocates say community can heal it
- Overdose education should be mandatory in B.C. schools amid opioid crisis, advocates say
- Mom mourns death of teenage son to toxic drug supply, government needs to act
- A Day in the Life: An RN in Northern BC
- Libby Davies: Why mandatory treatment doesn't work for drug users
- Victorians rally for safe supply, detox beds after two-week spike in toxic drug deaths
- ‘Connection is correction:’ reducing stigma and remembering those lost during Overdose Awareness Day
- Nothing about us, without us
- Carolyn Bennett hopes B.C.’s decriminalization plan reduces stigma around drug use
- Nurses Sound Alarm on Police Violence
- 'We are struggling': B.C.'s municipalities plead for province to act on toxic drug crisis
- Use of mass spectrometer drug testing developed in Nanaimo growing Island-wide
- Overdose Awareness Day in Duncan highlights need to ‘talk about it’
- Eby and Appadurai Differ on Compulsory Drug Treatment
- Death toll in Victoria’s toxic drug crisis continues to rise, with safe supply still missing
- As election approaches, consider how candidates address toxic drug crisis
- Officials investigating cause of five overdose deaths in one day
- HIV spike among B.C. drug users associated with COVID-19 lockdown, research says
- How data can improve health care for those who use drugs
- For Holden. I’ll Miss You Forever
- Victoria harm-reduction group receives $80,000 from province
- How Can Local Politicians Stem the Toxic Drug Crisis?
- 169 British Columbians killed by toxic drugs in August, coroner service says
Alberta:
Saskatchewan:
Manitoba:
Ontario:
- New safe-drug supply program in Thunder Bay, Ont., called 'a powerful step' forward
- Stories of love, loss shared at annual International Overdose Awareness Day ceremony in Peterborough
- Nearly 1,600 visits since Peterborough consumption and treatment site opened in June
- Kingston community marks International Overdose Awareness Day
- International Overdose Awareness Day: Time to respond meaningfully and urgently
- Why one Windsor, Ont. woman says everyone should be marking Overdose Awareness Day
- 5 events in Hamilton to mark International Overdose Awareness Day
- ‘We’re dying here’: A harm-reduction expert on the opioid crisis in northern Ontario
- Northern Ontario's Opioid Challenge
- 'Extremely concerning' spike in opioid-related calls for service
- Safer opioid supply program leads to drop in Ontario hospitalizations, ER visits: study
- As safe-supply study appears to show benefits for drug users, critics raise warning flag
- Hamilton clinic is prescribing safe, but strong opioids to counter the toxic supply of fentanyl
- ‘We don’t want to lose anybody’: Where do Barrie’s mayoral candidates stand on supervised drug-consumption sites?
- Sudbury, Ont., harm reduction worker stars in new documentary on the opioid crisis
- Safe haven for drug users awaits potential OK from province
- Move to generic methadone raises concerns
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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