Virtual safe drug-use plan halted
UCP calls monitoring threat of overdose by phone ‘dangerous’
Jason Kenney’s UCP government has pulled the plug on a virtual overdose response program led by the province’s health authority just hours before it was set to launch.
The program would have been dedicated to preventing overdoses in rural and suburban communities far from fixed supervised drug-use sites, which remain under review by the Alberta government.
Alberta Health Services’ virtual overdose response pilot project would have been the first of its kind in the province. It would have allowed clients to speak with a peer operator, tasked with monitoring them after substance use and dispatching emergency medical services if they become unresponsive.
Phone lines were expected to open Friday.
However, Alberta’s associate minister of mental health and addiction Jason Luan said in a statement late Thursday afternoon he had asked AHS to “pause” the project “pending realignment of our addiction and mental health policies.”
AHS has agreed to the pause. “I am deeply concerned about patient safety with a service of this nature,” said Luan. “Considering the use of illicit narcotics while on the phone with a peer support worker as an appropriate medical intervention is frankly dangerous.”
He said it’s unclear how long operators would remain on calls with clients and at what point they would dispatch medical services. He is also concerned clients may not have immediate access to naloxone.
Instead, he pointed to the government’s “safe services” in relation to addiction treatment and recovery spaces. He made no reference to harm-reduction programs that have proven successful in the province.
Postmedia made repeated requests to interview AHS about the project, all of which were declined. Instead, the agency offered a statement.
AHS said the virtual overdose response service would have lasted three years, to be funded by the Partnership for Research and Innovation in the Health System (PRHIS).
“This project will provide a virtual, phone-based peer support service for people struggling with addiction, where the operator will have the ability to connect the client with a full range of services and treatment options and co-ordinate a 911 dispatch to the location provided, should it be required,” AHS said in a statement earlier Thursday.
A staggering 80 per cent of overdose fatalities occur within the home, according to a government report on opioid-related deaths in 2017. This new service was dedicated to assisting drug users who are not generally served by current bricks-and-mortar supervised consumption sites.
Last year, Alberta Health Services was awarded $900,000 to develop the virtual overdose response program through a PRHIS grant by Alberta Innovates.
The goal of the project was to improve Albertans’ “experiences and health outcomes by removing barriers such as stigma, geographic distance and community resistance to supervised consumption services.”
The harm-reduction intervention would have complemented existing supervised consumption sites in Alberta, which have proven successful in reversing overdoses.
Since operations began at Calgary’s sole supervised drug-use site in October 2017 until May this year, Safeworks staff have responded to 1,821 overdoses.
There has also been a significant decrease in the rate of overdoses compared to the number of times drugs were consumed. In May 2020, that number sat at 1.42 per cent compared to 3.14 per cent in October 2017.
No deaths have been recorded. Drug-use sites have the greatest effect for clients within a 500-metre radius of the building, meaning those who live away from Calgary’s Beltline site, for example, are unlikely to benefit from the service. Similarly, neither will people far from other municipalities’ dropin sites.
“Virtual supervised consumption is a scalable intervention that can provide (an) evidence-based harm reduction service to Albertans who do not access the current (supervised consumption services),” said the AHS project description.
The city of Calgary, Telus, emergency service agencies, healthcare professionals, people with lived experience of drug use, mental-health and addictions experts, university researchers and the B.C. Centre for Disease Control all collaborated on the project.
Similar programs have been employed across Canada.
In B.C., the Lifeguard App is a downloadable resource for people at high risk of overdose. The user can activate the application before taking their dose. After 50 seconds, the app will sound an alarm, prompting the user to tap a button to indicate they’re fine.
If they don’t, the alarm grows louder.
After 75 seconds, a text-to-voice call will go straight to 911 to alert dispatchers to a potential overdose.
Dr. Elaine Hyshka, assistant professor at the University of Alberta’s School of Public Health, said it’s crucial that Alberta implement additional services to support the province’s drug-using population.
“We just need to be able to provide as many tools as we can to keep people as safe as possible until they are able to connect to services or get care,” said Hyshka.
“The mortality related to overdose is so extreme that we really do need to continue to innovate in our services and find new approaches, because clearly everything that we have been doing has been helpful but it’s not enough.”
From January to March, 142 people in Alberta died from accidental opioid overdoses.
Virtual services have the ability to reach a new population of people who are using substances and are at high risk of overdose, said Hyshka. It can help alleviate stigma, fear of criminalization and help people who are not within proximity to existing sites.
Alberta has found success with some online drug-treatment programs, such as the virtual opioid dependency program that was the recipient of a patient experience award by the Health Quality Council of Alberta.
This program uses a virtual clinic model for clients referred for opioid agonist therapy. Assessment, treatment and support are provided through video, phone or texting, while medications are delivered by a local pharmacist.
The phone-based overdose response service was set to launch while the future remains uncertain for existing supervised consumption sites in the province.
In early March, a review ordered by the UCP government into supervised drug-use sites in Alberta found “serious problems” with the way services operate.
Kenney’s government is set to decide on whether the sites will remain, close or be forced to relocate. There has been no update on the future of Calgary’s sole Safeworks site.
The merits of supervised consumption services as a tool for harm reduction was not considered within the scope of the Ucp-mandated review.