Results of the 2013 Annual Drug Survey

For the second year in a row, a survey was administered to clients at harm reduction distribution sites across BC to measure province-wide substance use trends and to inform future harm reduction service planning. The 2012 survey was amended to address common concerns raised by stakeholders and questions were added on crack pipes, equipment sharing, and overdose experiences. The survey was distributed to 34 harm reduction distribution sites in the five geographic health authorities in July 2013, and data analysis began in September.

Based on the 779 surveys completed:

• The most frequently reported substances were marijuana (51%), alcohol (48%), and crack (47%)
• Crack use (74%)  and cocaine use (42%) were highest in Northern Health Authority
• Crystal meth use was highest in Fraser (50%) and Vancouver Island (50%) Health Authorities
• Heroin use was highest in Fraser (49%) and Vancouver Coastal (48%) Health Authorities
• Approximately 50% of respondents who use injection drugs had difficulty finding needles in the past month, and 8% had injected with a used needle
• Of respondents who smoke crack, 50% had difficulty finding pipes in the past month, and 78% had shared a crack pipe or mouthpiece
• In the past 6 months, 16% had overdosed and 36% had witnessed an overdose
• Respondents who had used any opioid in the past week were twice as likely to have overdosed in the past 6 months than those who had not used any opioids  

We are grateful to harm reduction sites and their clients for their participation, and to the Centre for Addictions Research BC who provided funding assistance.

Communicating Drug Alerts

Currently BC lacks evidence-based guidelines for issuing alerts about overdoses due to changes in drug potency or the presence of toxic substances in street drugs. A lack of consistent guidelines may serve to increase harms with alerts unintentionally sending the message that drugs have 'improved' in strength rather than act as a warning. We are also aware that too frequent alerts may cause people who use drugs to become ‘immune’ to their significance and ignore the content of the notices.

We conducted a literature review to identify published best practices for communicating warnings and alerts. We also conducted three focus groups with peers and one-on-one interviews with service providers. Following qualitative analysis of the transcripts, we will develop and share the guidelines with our harm reduction community partners in BC and across Canada.

We appreciate the insights and experiences shared by all participants, and for funding assistance provided by the Canadian Community Epidemiology Network on Drug Use.