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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!
The Global State of Harm Reduction 2022 - Harm Reduction International: The Global State of Harm Reduction is the only report that provides an independent analysis of harm reduction in the world. Now in its the eighth edition, the Global State of Harm Reduction 2022 is the most comprehensive global mapping of harm reduction responses to drug use, HIV and viral hepatitis. This edition includes: Data on the availability of safer smoking kits & stimulant pharmacotherapy, for the first time; A chapter on the ongoing impact of the COVID-19 pandemic on harm reduction; Data on the number of people who inject drugs and the number of people in prison for drug use globally; and, Key legal/policy developments related to harm reduction and drug policy. Download it now!
First Survey on Safer Supply in Quebec: This is the first survey report on safer supply in Quebec conducted by L'Équipe de soutien clinique et organisationnel in collaboration with the Community of Practice in Addiction Medicine and the Montreal regional public health department. Download it now!
Nurturing Circles of Care - Subject Matter Health Research Lab: This animated video was created to explore the compounding effects of colonialism and institutional racism on the experience of stigma for Indigenous peoples with opioid use disorder. It addresses how stigma is experienced differently by everyone, and how we can work together to nurture circles of care and move beyond stigma. The project was informed by lived experiences and in partnership with clinicians and academics. This video was endorsed and disseminated widely to both national and international audiences. Captions available in Inuktitut [English (Ireland)], Mi’kmaq [English (United States)], English, and French.
Contributions of Stimulants and Varying Modes of Drug Use to Opioid Toxicity Deaths Across Public Health Units in Ontario, Canada - Ontario Drug Policy Research Network: Factors that have contributed to the increasing rates of opioid-related toxicity deaths in recent years include changes in the drug supply and pandemic-related changes in the availability and accessibility of services supporting those who use drugs. These factors are reflected in the changing circumstances around opioid toxicity deaths, including what and how drugs are being used. Polysubstance use and changing modes of drug use are important to understand as they can contribute to differing risks of harms among people who use drugs. This report examines the involvement of stimulants overall, and specifically non-pharmaceutical stimulants (i.e., cocaine and methamphetamines), as well as modes of drug use (e.g. inhalation/smoking vs. injection) in accidental opioid toxicity deaths occurring in Ontario between January 2018 and June 2021. Download it now!
Closing Gaps, Reducing Barriers: Expanding the Response to the Toxic Drug and Overdose Crisis - Select Standing Committee on Health, Legislative Assembly of British Columbia: This is the First Report of the Select Standing Committee on Health for the Third Session of the 42nd Parliament: Closing Gaps, Reducing Barriers: Expanding the response to the toxic drug and overdose crisis. This report covers the Committee’s work in regard to the examination of the urgent and ongoing illegal drug toxicity and drug poisoning crisis. Download it now!
Fentanyl Patch: Prescribed Safer Supply Protocols - PHS Community Services, British Columbia Centre on Substance Use, and Government of British Columbia: In July 2021, the Ministry of Mental Health and Addictions, Ministry of Health, and Office of the Provincial Health Officer released Access to Prescribed Safer Supply in British Columbia: Policy Direction, which enables individuals to access a range of medications through prescription to reduce the risk of drug toxicity death due to accessing the illicit drug supply. The first phase of implementation of this policy allows for the prescribing of certain opioids through regional health authority-run programs and federally funded programs (e.g., SAFER). Prescribed pharmaceutical alternatives is not intended for treatment of substance use disorders but is primarily a harm reduction approach as one strategy for reducing the risks of illicit drug toxicity events and deaths. The new prescribed safer supply protocols are being developed and released in a phased approach to support the implementation of emerging approaches for prescribed safer supply in BC, beginning with fentanyl patches with resources for sufentanil and Fentora to follow. These protocols will be updated as evidence is collected and practices are evaluated.
Updated Depot Guide and Patient Handouts - META:PHI: META:PHI has updated the depot guide and patient handout, as well as added a quick-reference tool, including rapid depot buprenorphine initiation options. Sublocade Treatment: What to Know and Expect, Initiation of Buprenorphine Extended-Release (BUP-XR) Injection, and A guide to the use of depot buprenorphine.
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RESEARCH PAPER OF THE MONTH
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Haines, M., Tefoglou, A., & O'Byrne, P. (2022). Safer Supply Ottawa Evaluation: Fall 2022 Report. https://safersupplyottawa.com/research/
Highlights:
- This report seeks to provide an overview of the 3 Safer Supply programs in Ottawa as well as the results of a program evaluation undertaken in the summer of 2022.
- Medical chart data for all current Safer Supply Ottawa participants was collected and analyzed. Overall, we found that over 70% of participants reported a decrease in their fentanyl use since starting a Safer Supply program. Further, of those participants who reported experiencing drug overdoses at program intake, 81% reported experiencing no overdoses at their most recent Safer Supply program check-in.
- A qualitative study including interviews and surveys was undertaken to speak directly with Safer Supply participants about their experiences within the program. From the surveys, participants reported improvements in their mental health, decreases in their fentanyl use, more stability in their housing status and income sources, decreases in overdose events, and less frequent participation in criminalized behaviour since starting Safer Supply.
- From the interviews, 3 broad themes arose, including 1) the context of substance use, 2) the process of Safer Supply programs, and 3) envisioning the future of Safer Supply. Participants also provided key messages about Safer Supply for policymakers and politicians.
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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.
- Pilarinos, A., et al. (2022). Methadone Maintenance Treatment Discontinuation Among Young People use who Opioids in Vancouver, Canada | Canadian Journal of Psychiatry
- Norton, A., et al. (2022). Injecting drugs alone during an overdose crisis in Vancouver, Canada | Harm Reduction Journal
- Cassie, R., et al. (2022). Difficulty accessing supervised consumption services during the COVID-19 pandemic among people who use drugs in Vancouver, Canada | Harm Reduction Journal
- Morford, K. L., et al. (2022). The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study | Drug and Alcohol Dependence
- Schneider, K. E., et al. (2022). Increased Solitary Drug Use during COVID-19: An Unintended Consequence of Social Distancing | International Journal of Drug Policy
- Lin, C., et al. (2022). Telemedicine along the Cascade of Care for Substance Use Disorders during the COVID-19 Pandemic in the United States | Drug and Alcohol Dependence
- Carter, J., et al. (2022). Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study | Addiction Science & Clinical Practice
- Nesoff, E. D., et al. (2022). City streetscapes and neighborhood characteristics of fatal opioid overdoses among people experiencing homelessness who use drugs in New York City, 2017–2019 | International Journal of Drug Policy
- McLauchlan, L., et al. (2022). “It's professional but it's personal”: Participation, personal connection, and sustained disagreement in drug policy reform | International Journal of Drug Policy
- Kleinman, R. A., et al. (2022). Methadone-involved overdose deaths in the United States before and during the COVID-19 pandemic | Drug and Alcohol Dependence
- Paul, L. A., et al. (2022). Evaluation of the gap in delivery of opioid agonist therapy among individuals with opioid-related health problems: A population-based retrospective cohort study | Addiction
- Fleury, M. J., et al. (2022). Predictors of Death From Physical Illness or Accidental/Intentional Causes Among Patients With Substance-Related Disorders | Canadian Journal of Psychiatry
- Philbin, M. M., et al. (2022). Age-related patterns of cocaine and methamphetamine use across the life course in the United States: disparities by gender and sexual identity among adults | Addictive Behaviors
- Healy, R., et al. (2022). ‘As for dignity and respect…. me bollix’: A human rights-based exploration of service user narratives in Irish methadone maintenance treatment | International Journal of Drug Policy
- Swigart, T., & Lee, L. (2022). “I'm putting a Band-Aid on a bullet hole the only way I know how:” a qualitative study of barriers and facilitators to opioid misuse and recovery in Nevada | Substance Abuse Treatment, Prevention, and Policy
- Palis, H., et al. (2022). Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study | Substance Abuse Treatment, Prevention, and Policy
- Crepeault, H., et al. (2022). Examining fentanyl and its analogues in the unregulated drug supply of British Columbia, Canada using drug checking technologies | Drug and Alcohol Review
- Morin, K. A., et al. (2022). Community trial evaluating the integration of Indigenous healing practices and a harm reduction approach with principles of seeking safety in an Indigenous residential treatment program in northern Ontario | BMC Health Services Research
- Konstantelos, N., et al. (2022). Impact of Policy Changes and Drug Shortages on Acamprosate and Naltrexone Use in Ontario, Canada | Drug and Alcohol Dependence
- Chase, J., et al. (2022). Self-injecting non-prescribed substances into vascular access devices: a case study of one health system’s ongoing journey from clinical concern to practice and policy response | Harm Reduction Journal
- Matskiv, G., et al. (2022). Virtual overdose monitoring services: a novel adjunctive harm reduction approach for addressing the overdose crisis | Canadian Medical Association Journal
- Guan, Q., et al. (2022). New opioid use and risk of opioid-related adverse events among adults with intellectual and developmental disabilities in Ontario, Canada | BMJ Psych Open
- Kiburi, S. K., et al. (2022). Digital interventions for opioid use disorder treatment: A systematic review of randomized controlled trials | Journal of Substance Abuse Treatment
- Alexander, B. K. (2022). A final conversation with addiction professionals | Addiction Research & Theory
- Beckett, M., et al. (2022). Inpatient care provider perspectives on the development and implementation of an addiction medicine consultation service in a small urban setting | Substance Abuse Treatment, Prevention, and Policy
- Ivsins, A., et al. (2023). A scoping review of qualitative research on barriers and facilitators to the use of supervised consumption services | International Journal of Drug Policy
- Hu, K., et al. (2022). Spatial-temporal trends in the risk of illicit drug toxicity death in British Columbia | BMC Public Health
- Perri, M., et al. (2023). Spotting as a risk mitigation method: A qualitative study comparing organization-based and informal methods | International Journal of Drug Policy
- Mamdani, Z., et al. (2022). ‘We are the first responders’: overdose response experiences and perspectives among peers in British Columbia | Drugs: Education, Prevention and Policy
- Betsos, A., et al. (2022). Beyond co-production: The construction of drug checking knowledge in a Canadian supervised injection facility | Social Science & Medicine
- Boucher, L. M., et al. (2022). “They have their security, we have our community”: Mutual support among people experiencing homelessness in encampments in Toronto during the COVID-19 pandemic | SSM - Qualitative Research in Health
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COMMUNITY UPDATES & EVENTS
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On the 1st of December 2022 - the 44th Anniversary of World AIDS Day - we grant that there have been many advances relating to HIV treatment since the dark years of the 80s. Today, an HIV diagnosis is no longer a death sentence, but this is not true globally for all PLHIV (People Living with HIV). There is still widespread misinformation and many PLHIV face discrimination, incarceration, and ostracization due to misconceptions relating to their diagnosis.
It is important for us to remember that in many countries access to medication and testing is still a challenge due to homophobia, transphobia, HIVphobia, religious beliefs, stigma, the cost of medication, and shame. Moreover, supporting services, including harm reduction, safe(r) supply, housing, mental health, addiction, and understanding how the intersectionalities of colonialism, racism, and the effect of the social determinants of health on PLHIV are lacking in many countries.
We honour those who have passed, the advocates, and those still living and fighting for an eradication of HIV/AIDS internationally through education, ensuring accessibility to medication, and continue to challenge the stigma that PLHIV still face.
Colin H. Johnson, on behalf of the Action for Safer Supply Working Group
National Safer Supply-Community of Practice (NSS-CoP)
BC ECHO on Substance Use Session - Opioid Agonist Treatment (OAT) and Pharmacy: The next BC ECHO on Substance User session is happening on Thursday, January 26th, 2023 from 12-1pm PST | 3-4pm EST. Dr. Mona Kwong's presentation will: describe OAT options, identify common drug-drug interactions with opioid agonist treatment medications, help avoid common errors when writing opioid agonist treatment prescriptions, and describe the logistics of pharmacy opioid agonist treatment administration, including witnessed ingestion, take-home doses, and prescription cancellations. Register now!
Stimulus Connect 22 - Safer Bathrooms: This upcoming Stimulus Connect will feature a presentation and discussion about the newly published Safer Bathroom Toolkit on Thursday, December 8th, 2022 from 10am – 12pm Pacific | 11am – 1pm Mountain | 12pm – 2pm Central | 1pm – 3pm Eastern | 2pm – 4pm Atlantic | 2:30pm – 4:30pm Newfoundland and Labrador. Register now!
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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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