This blog post is part of our series which highlights sessions of the 2018 National Conference on Ending Homelessness. Hear Katrina Milaney and Meagan Bristowe speak on Monday, November 5th at 1:30 PM. Learn more about this upcoming conference presented by CAEH. 

Health Canada recently updated the Canadian Drugs and Substances Strategy (CDSS) which is described as a “comprehensive, collaborative, compassionate and evidence-based approach to drug policy.”  The CDSS replaces the former National Anti-drug Strategy and includes four pillars:  prevention, treatment, harm reduction and enforcement. The intent of the strategy is to help prevent problematic drug use, support innovative approaches to treatment and rehabilitation, support measures to reduce harms associated with drug use and to address illicit drug production, supply and distribution. A primary driving factor of the updated strategy is to facilitate innovative responses to the current opioid crisis. 

In Alberta in 2011, six deaths were reported related to fentanyl use. By 2016 this number had skyrocketed to 368 and by the midpoint of 2017, 246 deaths were reported. This is a 6033% increase in six years. In Alberta, “[i]n the first quarter of 2017, there were 2,402 emergency and urgent care visits related to opioids and other substances of misuse”. This is significantly more than the first quarter of 2016, when there were 1,919 emergency and urgent care visits. Emergency room visits specifically due to opioid poisoning were 57% higher in Alberta than in Ontario in 2014-2015.

The Calgary Coalition for Supervised Consumption Services (CCSC) includes 19 partner organizations including health services, police, emergency shelters and social service organizations. They formed in 2016 to develop innovative solutions to deal with this crisis. In the summer of 2017, the CCSC partnered with the University of Calgary to conduct a needs assessment towards development of supervised consumption sites (SCS) in Calgary. Funded by Alberta Health, we led a scoping review of literature to assess best practices for harm reduction interventions and administered a survey to 370 participants who are actively using drugs. The survey was designed to elicit data on participants’ health issues, housing stability, patterns of drug use, experience with overdose and needs for harm reduction and supervised consumption services.  

Preliminary results showed that most published literature is focused on the general adult population, maintenance and substitution programs and lacked innovation. Many of the sub-populations we identified (women, youth, Indigenous Peoples) were not addressed in the harm reduction literature. The lack of focus on vulnerable subpopulations indicates a need for more granularized research and underlines the challenge posed in attempting to design appropriate interventions and changes to public policy. Analysis of the survey showed that most people who experienced an opioid overdose were experiencing homelessness or housing instability and were not aware they were taking opioids nor how strong they were. 

At the National Conference on Ending Homelessness in Hamilton this year, we will present the findings from both the scoping review and the survey to highlight current gaps in knowledge that limit our ability to adequately respond to the current opioid crisis in Canada.