Overdose deaths show no sign of slowing down since 2016, with over 3,800 deaths in BC reported as of November 2018 but a program in Vancouver to help keep people with opioid-use disorder in treatment is being expanded across BC.
The BC Centre for Excellence in HIV/AIDS (BC-CfE) and VCH created the Best Practices in Oral Opioid AgoniSt Therapy (BOOST) Collaborative as a pilot project in 2017. Seventeen clinical teams worked with more than 1,000 clients to help them remain on opioid agonist therapies (OAT) such as methadone and Suboxone. The needs of people with opioid use disorder are different – many face unstable housing, lack of family support, poverty and lack the means to get the care they need to avoid having a fatal overdose. This means it is crucial to proactively reach out, identify, engage and follow up with people. Staff came up with ways to better reach out to clients, such as increasing follow-up calls.
After 90 days, the number of people retained in treatment increased from three out of 10 to seven out of 10. The hope is that as people stay on treatment, they will stop or reduce their use of illegal substances, and not overdose or overdose less frequently.
"Opioid agonist therapies actually can decrease mortality by about 80% - so actually save lives," said Dr. Rolando Barrios, senior medical director at BC-CfE, who also works at VCH. "So the question for us is how we scale up that treatment and how we support people on the treatment so they benefit from the effects of that medication."
The BOOST strategy is built on lessons learned from a successful BC-CfE program launched in 2010 called Seek and Treat for Optimal Prevention of HIV/AIDS, or STOP HIV/AIDS.
"The BC-CfE applied lessons from its proven effective HIV strategy, which drove a steady and consistent decline in HIV and AIDS, to address the urgent opioid overdose crisis affecting individuals and families provincewide," said Dr. Barrios. "Small-scale improvements in care, implemented through the work of VCH health care teams, created major positive impacts on the lives of those affected by opioid use disorder. We can now apply these concepts to every region in BC."
If you or someone you know may be interested in support for opioid-use disorder visit our Substance use services page.