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B.C. overdose prevention sites should be template for others: report

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VANCOUVER — It was a day Heather Hobbs recalls vividly: the staff at AIDS Vancouver Island had pulled another overdose victim from the washroom, his body was blue from a lack of oxygen.

The man was revived and they closed the office in Victoria to allow staff to regroup. At the same time, in an alley just a half a block away, another of their clients was dying from an overdose.

Hobbs said she remembers seeing the man leave the facility as they began cleaning up from the overdose. His death was the tipping point for the implementation of an overdose prevention site at their facility, even though they weren’t yet legal, she said.

“I feel like it’s possible, had we not had to have closed, that he would still be alive. So it’s those moments that stick with me and really drive it home that these spaces are essential in terms of keeping people alive,” said Hobbs, who is the manager of harm reduction services for AIDS Vancouver Island.

In April 2016, the B.C. government declared a public health emergency in the overdose crisis, allowing for the unprecedented implementation of the prevention facilities. Within weeks, 20 sites had mushroomed around the province.

A new study by researchers at the Canadian Institute for Substance Use Research concludes the rapid implementation of the sites should be used as a template for other governments to save lives.

The study says the quick response of the provincial government and community groups is an “international example of an alternative to the lengthy and cumbersome sanctioning processes for (supervised consumption sites.)”

The report, published this month in the International Journal of Drug Policy, says other government demands for public consultations and an intensive application process “are highly questionable in the context of legal drug poisonings and evidence-based alternatives such as (overdose prevention sites.)”

Health Canada approves the supervised consumption sites, which require an exemption from federal drug laws, while the overdose prevention sites in B.C. are sanctioned under the provincial health minister’s declaration of a public health emergency.

Bruce Wallace, co-author of the report, a scientist at the institute and an associate professor at the University of Victoria, said the study demonstrates how unnecessary the approval process is elsewhere.

“Our research is showing that the benefits of being able to have overdose prevention sites at so many different locations and really integrated with housing, health and social support is a model to go for, rather than going back to the federal processes, which are more onerous to set up and more limited in scope.”

The BC Coroners Service said 991 people died of illicit drug overdoses in 2016, 1,486 died the next year and 1,510 were killed by illicit drugs in 2018. The dramatic rise in deaths coincides with emergence of the powerful opioid fentanyl, which the coroner says is responsible for the majority of illicit drug deaths.

Canada’s Public Health Agency said last week that 3,286 people died of apparent opioid-related deaths between January and September last year.

The report draws on interviews from staff at three of the prevention sites in Victoria to determine their impact.

Wallace said he’s frustrated that other jurisdictions in Canada aren’t adopting the same innovate practices to save lives, especially because they’ve been warned that dangerous opioids are moving into their provinces. 

“So to have that level of warning of the potential harm and not act, it’s really tragic that people would not take these lessons and adopt them as fast as they can in other jurisdictions.”

The Ontario government announced in late March that while 15 overdose prevention sites had been approved, six others would close, including three in Toronto.

Judy Darcy, B.C.’s mental health and addictions minister, said there are about 40 overdose prevention sites across B.C. with over one million visits. Thousands of overdoses have been reversed and there have been no deaths at the sites, she added. 

Darcy said it’s estimated the government’s actions, including the prevention sites, take-home naloxone kits and other prevention measures, have saved about 4,700 lives.

She said the prevention sites are a critical tool that also connect visitors to other supports, such as housing or treatment. But the stigma remains, Darcy said, and that is the next barrier to knock down.

“For too long we have treated mental health, mental illness as a sign of weakness and addiction as a character failure and as a sign of moral failure,” she said. “These centres don’t judge people. They’re there to save lives, they’re there to connect people to the social supports they need.”

Terri Theodore, The Canadian Press

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Laura’s story: I Feel So Much Better

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Health issues surfaced in the summer of 2020 for Laura. She had chest pain often and ended up in emergency a few times. She did have a small cardiac event in July. Her blood sugars were very high and all over the map during this time. Her blood pressure was also way too high.  She knew her weight was an issue to her health.  She had been diagnosed with Type 2 Diabetes a few years before this but had not tested her sugars for most of that time. All in all, this was a scary time for her.

Her doctor sent a referral to the Family Nurse in the clinic. He helped her to change her medication to less but more focused to her present condition. She found the nurse very positive, encouraging and available to meet her needs. Talking to the nurse regularly kept her accountable. She now enjoys smaller portions or healthier foods. Although it took some extra encouragement from the nurse, she now exercises on her treadmill regularly and is actually enjoying it. She no longer feels winded when she walks. She has lost 34 pounds; her blood pressure and blood sugars are both the normal range.  Laura says she used to feel like she could just drop but now actually feels energetic and less irritable. The other positive benefit of living healthier is that her self-esteem is way up! Laura still has weight to lose but feeling so much better is great motivation to continue this healthy journey.

To learn more about the RDPCN programs, visit www.reddeerpcn.com

Grant’s story: Amazing Improvement with Hard Work & Support

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Alberta

Covid no longer means special measures. Province brings treatment in line with flu and other viruses

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Adapting COVID-19 measures to support Albertans

With strong vaccine uptake, Alberta will gradually bring COVID-19 measures in line with other respiratory viruses to ensure health system capacity for the fall.

Nearly 75.6 per cent of eligible Albertans have now received at least one dose of COVID-19 vaccine, and 64.3 per cent are fully immunized. Vaccines dramatically reduce the risk of severe outcomes and the risk of infection. While COVID-19 cases may rise in the coming months, a surge of hospitalizations and other severe outcomes is much less likely thanks to vaccines.

In the coming weeks, Alberta’s health system will take steps to make sure that it is ready to support all patients, including those with COVID-19 and other respiratory viruses, like influenza, which health officials expect to increase this year.

As a part of this, Alberta will bring COVID-19 quarantine, isolation, and other measures in line with those used for influenza and other viruses.

Testing for severe cases, provincial monitoring, outbreak management in high-risk settings, and other key measures will remain in place. Health officials will be able to adapt as needed if hospitalizations due to COVID-19 spike in the future.

“Our health system will keep protecting Albertans who are exposed to COVID-19 while also ensuring that we are able to handle all other viruses and illnesses. As the majority of us are vaccinated against COVID-19, we are adapting to make sure that the health system is ready to care for all Albertans, whatever their illness. Please get vaccinated to help protect your health and the health of those around you.”

Tyler Shandro, Minister of Health

“Our top priority is supporting the health of Albertans. COVID-19 is still with us but we are now in a place where we need to manage it through vaccinations and the proven public health measures used for other communicable viruses. We expect to see increased influenza and other viruses this year, and these changes will make sure the health system is ready and able to support all Albertans in the months ahead.”

Dr. Deena Hinshaw, chief medical officer of health

A two-phase transition will be used to safely monitor the impact of the initial changes, adapt as needed over the next few weeks, and give more time to vaccinate Albertans.

The following changes will be effective July 29:

  • Quarantine for close contacts will shift from mandatory to recommended. Isolation for anyone with COVID-19 symptoms and for confirmed positive cases is still required.
    • Unimmunized individuals who know they have been exposed to COVID-19 should monitor for symptoms and seek testing if they become symptomatic.
    • Anyone who is not fully immunized should avoid high-risk locations such as continuing care facilities and crowded indoor spaces if they have been in contact with a case in the past 14 days.
  • All positive cases will continue to be notified. Contact tracers will no longer notify close contacts of exposure. Individuals are asked to inform their close contacts when informed of their positive result.
  • Contact tracers will continue to investigate cases that are in high-risk settings such as acute and continuing care facilities.
  • Outbreak management and identification will focus on high-risk locations, including continuing and acute care facilities and high-risk workplaces. Community outbreaks with a surge in cases leading to severe outcomes will also be addressed as needed.
  • Asymptomatic testing is no longer recommended. Testing will continue to be available for individuals who are symptomatic.
  • Mandatory masking remains in acute and continuing care facilities, publicly accessible transit, taxis and ride-share.

The following changes will take effect on Aug. 16:

  • Provincial mandatory masking orders will be lifted. Some masking in acute care or continuing care facilities may still be required.
  • Isolation following a positive COVID-19 test result will no longer be required, but strongly recommended.
    • Individuals with symptoms of any respiratory infection should still remain at home until symptoms have resolved.
    • Staying home when sick remains an important way to care for those around us by not passing on any infection.
  • Isolation hotels and quarantine support will no longer be available.
  • Testing will be available for Albertans with symptoms when it is needed to help direct patient care decisions.
    • This testing will be available through assessment centres until Aug. 31 and, after that, will be in primary care settings including physicians’ offices. For those with severe illness requiring urgent or emergency care, testing will be available in acute care and hospital settings.
    • COVID-19 testing will also be offered as needed in high-risk outbreaks such as in continuing care facilities.
  • Public health will focus on investigating severe cases that require hospitalization and any deaths due to COVID-19.
  • Outbreak management and preventative measures will continue focusing on outbreaks in high-risk settings, such as continuing and acute care facilities.
    • Community outbreaks will continue to be addressed as needed.
    • Daycares and schools will be supported with measures that would be effective for any respiratory virus if outbreaks are identified.

Health officials will continue to closely monitor hospitalizations and other severe outcomes due to COVID-19 in the province. Additional measures will be taken, as needed, in specific facilities or areas where an outbreak is occurring leading to severe outcomes.

Universal masking will not be required in schools once students return. However, it is recommended as a temporary outbreak intervention in response to respiratory outbreaks. A guidance document to support return to schools is being finalized and will be released in mid-August.

A wastewater baseline testing program will also be launched to provide area trend information and monitor variants of concern. More details will be released in the coming weeks.

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