Opening Remarks
Speakers: Dr. Michael Krausz, Leadership Chair, UBC Addiction Research
Lynn Pelletier, Vice President, BC Mental Health and Substance Use Services
Minister Sheila Malcomson, Minister of Mental Health and Addictions
Dr. Franco Vaccarino, Chair, Scientific Advisory Council, Canadian Centre on Substance Use and Addiction
Video featuring: Smokey D, Artist and Advocate in the Downtown Eastside of Vancouver (https://www.cbc.ca/player/play/884378691744/)
Watch the recording here
Final Panel: The Things we Need to Do
Moderator: Dr. Vijay Seethapathy, Chief Medical Officer, BC Mental Health and Substance Use Services
Panelists: Sara Fudjack, Founder, UBC Student Recovery Community
Dr. Nickie Mathew, Medical Director, Complex Mental Health and Substance Use Services
Jenny Kwan, MP, Vancouver East
Dr. Michael Farrell, Director, National Drug & Alcohol Research Centre
Watch the recording here
Fentanyl intoxication or system failure - the current treatment system, its interventions and effects
Presented by: Dr. Michael Krausz, Leadership Chair, UBC Addiction Research
Watch the recording here
The overdose crisis from a global perspective
Presented by: Isabelle Giraudon. Principal Investigator, EMCDDA
Watch the recording here
The Ethical Imperative on Stopping the Crisis
Presented by: Dr. Gabor Maté, Author, Member of the Order of Canada
Watch the recording here
Escalating the response to the toxic drug poisoning crisis in British Columbia – A systems approach using a comprehensive package of interventions
Presented by: Carolyn Davison, Director, Overdose Evaluation & Monitoring, Ministry of Mental Health and Addictions and Guy Felicella, Peer Clinical Advisor, BC Centre on Substance Use
Watch Carolyn Davison's presentation here
Block 1: How to end the crisis?
Moderator: Katsy Concepcion, Research Assistant, Addictions and Concurrent Disorders Research Group
- VCH-VFRS Combined Overdose Response Team- Jonathon Gormick
- Exploring Socioeconomic Influences on Mortality and Mental Health in Vancouver from 1995-2017- Craig Hutton
- Sparing no pains: soothing the opioid crisis during a pandemic- Peter Johnson and John Christy Johnson
- Opioid Agonist Therapy: A Synthesis of Canadian Guidelines for Treating Opioid Use Disorder- Andrew Johnson
- Episodic Overdose Prevention Services (e-OPS): Evolving Harm Reduction within Healthcare Facilities- Nancy Chow, Andrew Kerr
- Overdose Prevention in Acute Care: Lessons Learned from Opening the St. Paul’s Hospital OPS- Carlin Patterson
Watch the recording here
Block 2: What can be done, what should be done?
Moderator: Melissa Vereschagin, Research Assistant, Mental Health Systems and Services Laboratory
- Association of Opioid Agonist Treatment with all-cause and cause-specific mortality among people with opioid dependence: a systematic review and meta-analysis- Thomas Santo Jr
- Collective Care: Traditional Wisdom in Modern Times- Len Pierre, Jordan White
- Patterns of post-discharge opioid dispensing following cesarean delivery in British Columbia: analysis of trends from 2004-2019- Stefanie Polderman
- The Great Amplifier: Opioid Overdose In Times of Disruption- Rob Johannes, Samim Hasham
- Virtual Consumption: Love in the Time of Covid- Oona Krieg
- Implementing Substance Use Simulation at an Urban Emergency Department: A Pilot Project- Amelia Birch, Nat Brewer
Watch the recording here
Workshops
1A. Why does Switzerland have no overdose crisis?
Speakers: Marc Vogel, Psychiatric Services, Division of Substance Use Disorders, Switzerland
Watch the recording here
1B. Why does Germany have no overdose crisis?
Speakers: Maurice Cabanis, Center of Mental Health, Hospital for Addiction and Addictive Behavior, Germany
Recording is not available
1C. Is there a Fentanyl crisis in Europe?- Isabelle Giraudon, Jean Westenberg
Speakers: Isabelle Giraudon, Principal Analyst, EMCDDA
Jean Westenberg, Graduate Research Assistant, UBC Department of Psychiatry
Recording is not available
Data sources covering the last decade on overdose deaths, drug treatment entrants and drug-related emergencies suggest that the health burden associated with opioid use is mostly related to the consumption of heroin – and to a lesser extent diverted opioid substitution treatment medications – and that it is primarily affecting an ageing cohort of vulnerable users, with little evidence of an increase in initiation. While opioid-related deaths are currently at much lower levels than in the United States, they still represent a large preventable health burden with differences across EU countries. There is also increasing concern related to the high availability of heroin, illicitly produced synthetic opioids and diverted opioid pain medications on the European drugs market. Trends in the latter categories are poorly monitored and we may miss signs of emerging problems. Moreover, the economic recession following the COVID-19 pandemic has a potential to lead to resurgence in opioid use and harms. This workshop will look at data from the European monitoring system to address the question of whether Europe is facing an opioid epidemic. It reviews available health and supply side indicators, considering the limitations of each data source. A summary of the available evidence would suggest that while opioid-related deaths in Europe represent a large preventable health burden with differences across EU countries, Europe as a whole is not facing an opioid crisis of the size and nature seen in the US.
1D. Drug markets and changing business models globally *Workshop cancelled*
1E. Investigative journalism and media on the overdose crisis
Speakers: Kathryn Gretsinger, Associate Professor of Teaching, UBC School of Journalism, Writing and Media
Moira Wyton, Health Reporter, The Tyee
Alex Kim, Producer, Crackdown podcast
Watch the recording here
What role does media play in the overdose crisis? How does the news, podcasts and social media impact the way we see this public health emergency? This panel discussion will touch on the role of media and journalism in the overdose crisis. Panelists will discuss topics such as how the overdose crisis is portrayed in the media, whether or not the crisis is covered enough in the media, and what media forms are successfully communicating this crisis with the audience. There will also be an an opportunity for attendees to ask questions to the panel.
1F. Opiate Overdose in Iran with highest prevalence rates of opiate use globally
Speakers: Kimia Ziafat, Graduate Research Assistant, UBC School of Population and Public Health
Kiana Kianpoor, UBC Medical Student
Watch the recording here
Download the slides here
1G. Experiences in Scotland
Speakers: Kirsten Horsburgh, Strategy Coordinator (Drug Death Prevention), Scottish Drugs Forum
Recording will be available soon
This workshop will explore the Drug Deaths Crisis in Scotland and the role of naloxone.
Scotland has the highest recorded rate of preventable overdoses in the whole of Europe. The national naloxone programme was introduced in 2011 and since then over 80,000 take-home naloxone kits have been supplied to those likely to witness an overdose. It is without a doubt that had naloxone not been available in this way, that the deaths would have been even higher. In 2019, a Drug Deaths Taskforce was introduced and at the beginning of 2021, a Drugs Policy Minister was appointed in the Scottish Government. This workshop will explain what this means for Scotland and explore what needs to be done in order to stop people dying from these accidental and preventable deaths.
1H. Why India does not have an overdose crisis (so far)
Speakers: Atul Ambekar, Psychiatrist, National Drug Dependence Treatment Centre, India
Recording will be available soon
1I. The Hidden Crisis: film premiere and discussion with filmmakers
Speakers: Jodi Higgs, Manager, Pacific Community Resource Society
Kim Lloyd, Supervisor, Pacific Community Resource Society
Mike K- Person with lived experience
Justin Booth- Videographer and Owner, Dock Visual Media
Watch a clip of the short film here
The Pacific Community Resources Society (PCRS) and Dock Visual Media have created insightful videos on the overdose crisis in the Fraser Health region. Featured in these videos is Mike, a man with lived experience who shares his story with substances. Join this workshop for the first-ever screening of the video and a Q and A session with Mike, the videographer, and the PCRS team.
1J. Me, my doctor, my fentanyl- lived experiences from the user and professional perspective *Workshop relocated to Block 3*
1K. UNODC-WHO S-O-S (Stop-Overdose-Safely) Initiative: Community management of opioid overdose *Workshop cancelled*
1L. Fentanyl intoxication or system failure - the current treatment system, its interventions and effects
Speaker: Michael Krausz, Leadership Chair, UBC Addiction Research
View the recording here
1M. Overdose situation in Alberta
Speaker: Monty Ghosh, Assistant Clinical Professor, University of Alberta and University of Calgary
This workshop will cover the overdose situation in Alberta, Canada. It will also touch on harm reduction and treatment during the COVID-19 pandemic in Alberta, including virtual consumption sites.
Download the slides here
2A. Needs-based planning for substance use disorders and concurrent disorders
Speakers: Daniel Vigo, Assistant Professor, UBC Department of Psychiatry & School of Population and Public Health
Brian Rush, Faculty Member, Dalla Lana School of Public Health
Watch the recording here
An integrated needs-based planning approach to the treatment of substance use and mental disorders will be demonstrated.
2B. Abstinence paradigm and overdose threat – do we need to stop detoxification? *Workshop cancelled*
2C. International Consensus on Treatment of High-Risk Substance Use and Increased Risk of Overdose Among Youth
Speakers: Jean Westenberg, Graduate Research Assistant, UBC Department of Psychiatry
Martha Ignaszewski, Child and Adolescent Addiction Psychiatrist
Watch the recording here
Download the slides here
Globally, youth-tailored services for high-risk substance use are rare and treatment paradigms for youth are mostly focused on abstinence, which is unlike treatment protocols for adults and not based on clinical research evidence. In this workshop, we will be presenting an international collaborative project that sourced best practices from international experts and established consensus on prevention, treatment, and management of high-risk substance use among youth through a Delphi process. This work addresses the gap in clinical practice and treatment guidance, identifies common ground, and promotes research on high-risk substance use in youth, all with the intention of improving the consistency of care for individuals below the age of 25 years. Improvements in treatment through consensus building should lead to necessary next steps of informing health care decision-makers and professional organizations. The work is just beginning. Without change, rising fatalities, especially through overdose, are unavoidable.
2D. Heroin assisted treatment in Canada: an answer to the overdose crisis?
Speakers: Scott MacDonald, Physician Lead, Providence Crosstown Clinic
Barb McKillip, Nurse Practitioner, Vancouver Coastal Health
Karen Arnold, Physician
Cheryl McDermid, Family Physician, Providence Crosstown Clinic and The Doctor Peter Centre
Watch the recording here
View the slides:
The Peter Centre: Community iOAT by Dr. Cheryl McDermid
iOAT Program: The Downtown Community Health Centre by Dr. Karen Arnold and Barb McKilip, NP
Experiences from 3 clinics in Vancouver, Canada by all speakers
Canada has seen a significant increase in opioid-related mortality over the past decade. To address this, Canada has placed significant emphasis on improving access to opioid agonist treatment (OAT); including injectable therapies (iOAT).Health Canada gave hydromorphone solution in the supervised model an indication for treatment of opioid use disorder in May of 2019 and at least 5 provinces have hydromorphone iOAT programs and are providing iOAT in the acute care setting. Hydromorphone is a useful tool, safe and effective yet some clinicians in Vancouver noted some patients were seeking diacetylmorphine or prescription heroin. To attract and retain even more people in care three clinics in downtown Vancouver have been offering diacetylmorphine solution in addition to the full continuum of opioid use disorder treatment options. Dr. Scott MacDonald will describe iOAT using diacetylmorphine and hydromorphone as a treatment options for individuals with a severe, refractory opioid use disorder at Crosstown Clinic. Dr. Karen Arnold and Barb McKillip will discuss the challenges and successes integrating iOAT with diacetylmorphine into Downtown Community Health Center. Dr. Cheryl McDermid will review the Dr. Peter Center’s success with diacetylmorphine and the role of a community compounding pharmacy in procuring solutions. These three different models of care may provide insight for development of similar programs across Canada.
2E. Fentanyl as a therapeutic agent in the crisis
Speakers: Vivian Tsang, Resident Physician, UBC
James Wong, Graduate Research Assistant, UBC Department of Psychiatry
Recording is not available
This session discusses the benefits and drawbacks of fentanyl, the history of the substance in medical and non-medical environments through history, and present day challenges that threaten the lives of people who use drugs.
2F. Does talking make any sense? The role of counselling in the overdose crisis
Speakers: Bernd Mueller, Registered Social Worker, Psychotherapist in Private Practice, Mueller Counselling
Ava Outadi, Research Assistant, UBC Department of Psychiatry
Watch the recording here
Download the slides here
During this workshop, we will talk about approaches that can help address substance use in therapy.
2G. COVID and Overdose prevention- learnings from the Pandemic
Speakers: Kimia Ziafat, Graduate Research Assistant, UBC School of Population and Public Health
Fiona Choi, Research Associate, UBC Department of Psychiatry
Watch the recording here
Download the slides here
2H. How to predict the risk of overdose?
Speakers: Andy Tai, Graduate Research Assistant, UBC Department of Psychiatry
Craig Hutton, Data Scientist & Behavioural Neuroscientist, Ministry of Social Development & Poverty Reduction
Watch the recording here
In this workshop, we will be discussing how to utilize clinical data to apply two different explanatory and predictive statistical approaches. The detailed goal of these approaches will vary, but have a similar aim of understanding the opioid crisis. Join us to discuss the challenges, pros and cons of each approach, as well as ongoing research with partnered British Columbia Centre for Disease Control (BCCDC).
2I. Routes of administration for high potent opioids in OAT treatment in Switzerland
Speakers: Marc Vogel, Psychiatric Services, Division of Substance Use Disorders, Switzerland
Recording is not available
2J. Using the web for virtual help – Risk Assessment and Management (RAMP)
Speakers: Alireza Kazemi, Data Scientist, UBC Department of Psychiatry
Michael Krausz, Leadership Chair, UBC Addiction Research
Download the slides here
The Risk Assessment and Management Platform (RAMP) is a Health Canada funded e-mental health platform that aims to support people at risk of overdose. This platform is being developed by the Addictions and Concurrent Disorders Research Group at UBC. Drs. Alireza Kazemi and Michael Krausz will provide some information on the platform, its purpose and its development.
2K. The ethical imperative on stopping the crisis –
Discussion with Gabor Mate *Workshop full*
Speakers: Gabor Mate, Physician, Author, Co-founder of the Compassionate Inquiry Method
This workshop will be an extended Q and A session with Dr. Gabor Mate, renowned author and physician. Please note that this workshop will only be 15 minutes long. Attendees can go to a workshop that is not full or the Lightning Talk session for the remaining 45 minutes.
Watch the recording here
2L. Pandemic Innovation: Bringing Addiction Care and Harm Reduction to your Residence
Speakers: Melanie Willows, Addiction Medicine Physician, Clinical Director, Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre
Monty Ghosh, Assistant Clinical Professor, University of Alberta and University of Calgary
Recording is not available
Opioid deaths in Canada escalated by 74% during the first 6 months (April-September 2020) of the COVID pandemic.1 Rapid access addiction medicine (RAAM) clinics are low-barrier walk-in clinics that patients can attend to get help for a substance use disorder without an appointment or formal referral (self-referral).2 Since March 2020, the COVID pandemic has caused a shift in how services are provided through these RAAM clinics. This presentation will discuss innovative changes to service provision to accommodate public health mandates for physical distancing and stay at home orders. These include telehealth services, RAAM digital front door, and harm reduction resources such as the National Overdose Response Service (NORS).3
Learning Objectives
- Describe the Rapid Access Addiction Medicine (RAAM) model of care aimed at increasing access to care, improving treatment outcomes and reducing emergency room utilization.
- Discuss changes to service delivery due to COVID pandemic.
- Describe innovations aimed at improving access to care and preventing opioid overdose.
2M. University Student Perspectives on Substance Use and Harm Reduction on Campus
Speakers: Students from AMS Peer Support
Recording is not available
Volunteers from AMS Peer Support, a student-run mental health and harm reduction service, will be leading a discussion on the different ways substances are integrated into the university experience. Discussion will cover personal and observed experiences with substances on campus, strategies for harm reduction that folks use, and what support services are available to UBC students and residents of the Lower Mainland.
3A. What do professionals in BC think about safe supply? – results of cross sectional survey
Speakers: James Wong, Graduate Research Assistant, UBC Department of Psychiatry
Nick Mathew, Medical Director, Complex Mental Health and Substance Use Services, BCMHSUS
Recording is not available
Background:
In March 2020, BC announced new clinical guidance to provide pharmaceutical-grade drugs (safe supply) to people who use drugs with the aim of reducing their exposure to the illicit drug supply and Covid-19.
Methods:
From June-October 2020, we conducted an online survey of 159 physicians currently practicing in BC to examine their perspective and attitudes toward the guidance.
Results:
Support for the guidance was disparate: 45% supportive, 34% unsupportive, and 21% neutral. 95% and 68% felt there is a medium to high risk of diversion and worsening pre-existing psychosis, respectively. The most commonly suggested alternative was the decriminalization or legalization of drug use.
Conclusions:
Physician support and opinions regarding the guidance were split in many areas, but there was consensus on the risks of diversion and psychosis. Given these findings, the program and its outcomes need to be evaluated to inform the next steps of the overdose crisis response.
3B. Addiction Psychiatry - Role for effective collaboration in addressing the overdose crisis
Speakers: Vijay Seethapathy, Chief Medical Officer, BC Mental Health and Substance Use Services
Ronald Joe, Associate Medical Director, VCH Community Addiction Programs
Recording will be available soon
3C. Policing the overdose crisis: from enforcement to harm reduction
Speakers: Conor King, Inspector - Investigative Services Division, Victoria Police Department
George Budd, Research Associate-Mental Health Services Unit, Vancouver General Hospital
Watch the recording here
How sweeping changes in drug trafficking patterns contribute to the overdose crisis and how the law enforcement response has evolved.
3D. Translational research on new pharmacotherapies
Speakers: Lily Aleksandrova, Postdoc, UBC Department of Psychiatry
Tony Phillips, Professor, UBC Department of Psychiatry
Watch the recording here
Download the slides here
There is general agreement that current medications do not adequately address critical aspects of Opioid Use Disorder (OUD), as related specifically to withdrawal and relapse to drug-seeking behaviour. Unfortunately, the direct experience of withdrawal serves as major deterrent to seeking appropriate clinical assistance. For those in treatment, this aversive state may contribute significantly to relapse. Effective management of withdrawal would provide a gateway to effective treatment of OUD Accordingly, the main objective of this presentation is to briefly review the challenges related to successful voluntary detoxification from opioid dependence as a key step in gaining further clinical support to overcome chronic opioid use.
3E. My Fentanyl, my doctor, and my lived experience
Speakers: Pouya Azar, Addictions Psychiatry Lead, Foundry BC
Andy Tai, Graduate Research Assistant, UBC Department of Psychiatry (Moderator)
Recording is not available
3F. Connection in the face of addiction
Speakers: Sonali Kuber, Research Assistant, UBC Okanagan
Luca de Verteuil (Moderator)
Watch the recording here
Download the slides here
An immersive experience by the UBC Student Recovery Community. They are a peer-led community for students in recovery or curious about their relationship with addiction & addictive behaviours. They support all recovery pathways.
3G. Youth Case Competition finals: Innovation in the crisis
Moderator: Katsy Concepcion, Research Assistant, UBC Department of Psychiatry
Watch the recording here
This workshop will hold the finals for the Let's Talk Overdose Youth case competition. 15 teams of young people from across Canada and the world submitted solutions for new technologies, programs and innovations to help mitigate the impacts of the overdose crisis. Youth voices are incredibly important in ending the crisis. Attend this workshop to hear the top four teams present their solution in front of an expert judging panel for a chance at a cash prize and opportunity to further their research by becoming 'Youth Ambassadors' for the Addictions and Concurrent Disorders Research Group.
3H. Youth: A Needed Focus of the Overdose Crisis Response
Speakers: Students involved with the FentaNIL project
Watch the recording here
View the slides here
Founded in 2018 at the University of Alberta, The FentaNIL Project is a student-led initiative based out of universities across Western Canada. The FentaNIL Project aims to ameliorate the detrimental effects of the overdose crisis in our communities by facilitating free naloxone training, distributing take-home naloxone kits, and educating community members on overdose prevention strategies and synthetic opioids.
3I. Drug policy nearly ended my life and how harm reduction saved it!
Speakers: Guy Felicella, Peer Clinical Advisor, BCCSU
Recording is not available
This workshop will provide an opportunity to hear Guy Felicella's personal story, which will include the underlying issues of trauma, bad drug policies, harm reduction, recovery and how human connection saved him in the end.
Guy Felicella grew up in a middle class home in Richmond but fell into addiction at a young age. Guy spent 30 years in the repeated cycle of gangs, addiction, treatment and jail. He spent nearly 20 years residing in the two block radius in the Downtown Eastside and using many resources, including harm reduction, to keep himself alive. Today, Guy has escaped the grips of the turmoil that kept him suffering and resides with his wife and three young children with multiple years of recovery and sobriety under his belt. Guy is passionate about advocating for the vulnerable people who still suffer in addiction and educating communities on harm reduction to eliminate the stigma that exists around it. Currently Guy works for Vancouver Coastal Health, Ministry of Mental Health and Addiction and the BC Centre on Substance Use. In addition, Guy attends various school districts and post secondary institutions to educate students on addiction.
3J. Systemic Indicators of Overdose: what to do next?
Speakers: Kimia Ziafat, Graduate Research Assistant, UBC School of Population and Public Health
Jean Westenberg, Graduate Research Assistant, UBC Department of Psychiatry
Watch the recording here
Download the slides here
Opioid overdose is a global crisis with many countries experiencing an increase in fatalities worldwide. There is insufficient evidence on the systemic components of each country to allow for an effective response, and there are significant systemic differences between countries with high and low levels of overdose fatalities. To address this, a Delphi study is underway to obtain a consensus statement for the necessary system-level response to the changing patterns of drug use, drug scenes and addiction care from an international perspective. In the workshop, we will dive deeper into the international context surrounding substance use treatment and ask participants to provide external feedback regarding the study. We will also discuss potential domains that need to be addressed regarding the therapeutic continuum for people at risk of overdose and other severe adverse events.
3K. The overdose crisis from an Australian perspective
Speaker: Thomas Santo Jr, Ph.D. Candidate & Research Officer, National Drug & Alcohol Research Centre (UNSW Sydney)
Michael Farrell, Director, National Drug & Alcohol Research Centre
View the slides here
3L. Hope Writing Workshop
Speaker: Kathryn Gretsinger, Associate Professor, UBC School of Journalism
Recording is not available