The Best-practices in Oral Opioid AgoniSt Therapy (BOOST) Annual Congress was held last month amidst the dual public health emergencies of the COVID-19 pandemic and the opioid overdose crisis. Presenters at the congress shared how their teams are adapting their practices for the pandemic, how healthcare teams can better integrate the voices of families of those with opioid use disorder (OUD), and also shared ideas on how to support and improve retention for clients on opioid agonist therapy (OAT).
The most recent data from the BC Coroners Service shows 1,386 overdose deaths in BC between January and October of this year. Fentanyl was detected in 1,146 of these victims. As multiple health officials have noted, COVID-19 is contributing to an increasingly toxic drug supply and creating barriers for those who need to access harm-reduction services.
In response to these dangers, Provincial Health Officer Dr. Bonnie Henry signed an order in September giving more health professionals the ability to prescribe safer pharmaceutical alternatives.
In light of these changes, two mothers of young adults living with OUD shared their personal stories about helping their loved ones. Throughout her testimony one mother was emphatic about the importance of safe housing to those living with OUD. She told the congress about how much of a difference safe housing made to the life of her child and went on to talk about how mentoring and finding a purpose for people living with OUD were also critical to improving the day-to-day life of those with chronic substance use. Both moms spoke about how healthcare teams can include the families of those living with OUD in supporting their clients by creating a space for them to share information.
BOOST QI Network member Dr. Chris Kriek, with the Cornerstone Clinic serving BC’s Cariboo region, spoke of the challenges in promoting and educating people about OUD and OAT in such a remote area. With help from BOOST QI resources, Kriek has been able to educate emergency departments in his region, and says his goal is to reduce barriers for patients with OUD. Kriek said, “With BOOST, it’s really helped me as a family physician to improve the care I can give to my patients.”
Christine Massey, the newly appointed Deputy Minister of the Ministry of Mental Health and Addictions, also joined the congress. She praised the combined efforts of the BOOST QI Network and its participating teams other harm reduction teams, and said that by connecting people with OUD to OAT, expanding access to naloxone, and expanding overdose prevention services, BC has averted more than 6,000 deaths since April 2016, when the opioid overdose crisis was first declared a public health emergency.
Massey cited BC-CfE data and shared with the congress that about 83,000 people in BC likely meet the criteria for OUD with about 66,000 of those diagnosed. BC-CfE data also shows there are only about 22,000 patients on OAT at any given time, meaning only a quarter of people with OUD are engaged in treatment.
Massey said, “In the context of the dual health emergencies of COVID-19 and the illicit drug toxicity deaths across the province, the work of the BOOST QI Network is more important now than ever. Retention of patients on opioid agonist treatment plays a critical role in the province’s overdose response by providing treatment alternatives to the highly toxic, unpredictable, and unregulated drug supply. Opioid agonist treatment is saving lives, and we have the research to back it up.”