Health Professionals
Health professionals and service providers have an important role to play in harm reduction. This area contains resources and other information to help those on the front line and beyond.
Alerts
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Interior Health - Drug Alert - West Kootenay/Kootenay BoundaryDecember 02, 2021 • Posted by Interior Health
Interior Heath has issued a regional DRUG ALERT for West Kootenay/Kootenay Boundary areas and especially in the communities of Trail and Grand Forks after multiple drug samples tested were found to contain Carfentanil, Carfentanil analogues & Flualprazolam (a strong and long-lasting benzodiazepine analogue). There is a high overdose risk with possible sever consequences including death. In addition there is a risk for prolonged sedation.
For your safety:
- Get your drugs checked - find locations at drugchecking.ca
- Avoid mixing
- Use with others around or at an Overdose Prevention Site (OPS)
- Start with a small amount
- Carry naloxone and know how to use it
- Get the LifeGuard App - lifeguardh.com
- Call 211 or visit bc211.ca to find services near you
More information and drug checking results at https://drugchecking.ca/
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Northern Health - Overdose Alert - Quesnel December 02, 2021 • Posted by Northern Health
Northern Heath has issued an OVERDOSE ALERT for QUESNEL after an increase in overdose events in the community. The reported substance is light purple/blue in powder/ pebbles sold as down, when broken apart it turns pink.
This substance is highly toxic, causes heavy and prolonged sedation, and requires more naloxone to reverse. Overdoses are occurring when the substance is injected.
For your safety:
- Don't use alone, use in an OPS if possible
- If you plan to use alone, use the free Lifeguard or BeSafe app
- Don’t mix with other substances
- Carry and know how to use naloxone
- Call 911 or your local emergency number right away if someone overdoses
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BC Provincial Emergency AlertNovember 24, 2021 • Posted by Toward the Heart
BC Provincial Emergency Alert
Emergency Response Across BC
- The flooding/road closures may cause disruptions to the illicit drug supply across BC, which can increase toxicity and risk of overdose
- There is no shortage of naloxone in BC and we are working to ensure distribution to sites across the province
FOR YOUR SAFETY
- Use an Overdose Prevention Site, if you can. FIND AN OPS
- Pick up a naloxone kit and harm reduction supplies near you. Some distribution sites may be affected by delivery disruptions so when possible, check in with the site first FIND A SITE
- Get your drugs checked FIND A LOCATION
- Avoid using alone. Find a buddy or have someone check on you.
- When using with a buddy is not possible, consider using an app like Brave or Lifeguard or virtual spotting. How to spot someone by video or phone from CAPUD.
- Talk to your doctor or nurse practitioner about how to access prescription medications to reduce overdose risk and prevent withdrawal. Refer them to these guidelines or Click here for more info.
- Pharmacies in BC can provide emergency refills of prescription medications – check with your local pharmacy for emergency refills as needed.
THIS IS A PROVINCIAL ALERT
Check your local Health Authority websites for local alerts
Updated: November 24, 2021
Remove date: December 8, 2021
Timelines
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Harm Reduction Timelines
Opioid Substitution (Agonist) Treatment in BC
A timeline of Opioid Substitution (Agonist) Treatment in BC
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Naloxone Timeline
History of the Take Home Naloxone Program
A history of the Take Home Naloxone program in British Columbia
Information Sheets
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Naloxone
Naloxone FAQ
This document addresses frequently asked questions related to the drug Naloxone, which is provided through the BCCDC's Take Home Naloxone program.
Busting Naloxone Myths
Common myths about Naloxone are busted in this resource for harm reduction coordinators.
Naloxone Pre-Loading Concerns
This document addresses concerns with pre-loading naloxone into syringes for administration.
Naloxone and Temperature - PDF
This information provides information about naloxone exposure to heat and cold as well as storage temperature recommendations.
Naloxone Use in Pregnancy - PDF
Opioid overdose can cause anoxic brain damage and death. Administration of naloxone to a pregnant person can save the lives of the pregnant person and fetus. This information sheet addresses concerns about using naloxone in pregnancy.
Naloxone Use in Children - PDF
Death from unintentional drug overdose in children is preventable. Naloxone administration can save the life of a child and is safe. This information sheet addresses concerns about giving children naloxone.
Product Monograph - Teligent
This document contains information about the naloxone manufactured by Teligent. This product is included in the BC Take Home Naloxone and Facility Overdose Response Box programs. This product does not contain a preservative.
Product Monograph - Sandoz
This document contains information about the naloxone manufactured by Sandoz. This product is the secondary (back-up) product periodically included in the BC Take Home Naloxone and Facility Overdose Response Box programs. This product contains preservative. All sites will be notified if/when this product is used.
Teligent Product Info Sheet - Non Prescription Naloxone
This document contains information about the non-prescription naloxone manufactured by Teligent. This product is included in the BC Take Home Naloxone and Facility Overdose Response Box programs. This product is the same formulation as the Teligent prescription product, labelling differs to identify regulatory differences. This product does not contain a preservative.
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Fentanyl
Fentanyl and First Responders
This resource addresses common questions about the risk of fentanyl exposure to first responders and health care workers
Fentanyl-Induced Muscle Rigidity - PDF
Fentanyl-induced muscle rigidity, also known as “chest wall rigidity” and "wooden chest syndrome" is a complication of intravenous injection of fentanyl that has been recognized in the induction of anesthesia in hospital populations. This document provides a background as well as recommendations for by-standers as well as recommendations for safer substance use.
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Benzos/etizolam with opioids
Withdrawal from Benzodiazepines Mixed in the Illicit Drug Supply in BC
This information sheet for the general public provides information about withdrawal from benzos and benzo-like substances as it can be serious and require medical attention.
Benzos found in Opioids in BC - for Health Professionals
This summary sheet for health professionals provides information on the prevalence of benzos in opioids in British Columbia as well as drug checking, clinical considerations and additional resources.
Responding to an opioid overdose with benzos or etizolam
The following information outlines how benzos or benzo-like substances can complicate and delay opioid overdose response, and what to do if these substances are involved.
Etizolam in BC's Illicit Drug Market - Fact Sheet
This fact sheet provides information on etizolam and its presence in British Columbia's Illicit Drug Market.
Alert! Benzos on the Rise in Illicit Opioid Overdoses in BC
This article, written by Dr. Jessica Moe and published on the BC Emergency Network, outlines the prevelance of benzos in illicit opioids in BC and provides suggestions and resources for health care providers.
Potent sedatives in opioids in BC: implications for resuscitation,and benzos/etizolam withdrawal
This article, written by Purssell R, Buxton J, Godwin J, Moe J and published in BCMJ, provides information on implications for resuscitation, and benzodiazepine and etizolam withdrawal.
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Syringes
Single Use Syringes - PDF
This document addresses common concerns expressed in regards to the use of single-use syringes in the community.
Distribution Vs Exchange - PDF
This document summarizes why the BC Harm Reduction program follows a policy of needle distribution rather than one-for-one needle exchange.
Additional Resources
For further information regarding best practices related to needle distribution, safe needle disposal and community needle stick injuries, please refer to the Best Practice Recommendations and Guideline resources posted below.
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Why Give Breaths?
Why Give Breaths? - PDF
Opioid overdose is one of a number of special situations where the American Heart Association recommends a different approach than only chest compressions. This information sheet provides information on the importance of giving breaths when responding to an opiod overdose.
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Toxic Substances in the Supply
Levamisole Information Sheet
This information sheets provides an overview of Levamisole, how to tell if may be in substances, and healthcare recommendations for the general public.
Levamisole Information Sheet for Healthcare Professionals
This information sheet for healthcare professionals provides an overview of what levamisole is, the link with cocaine, a summary of typical presentationsand findings, risks and recommended care
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Outreach
Harm Reduction Supply Outreach
Tips for outreach services to maintain supplies and continue connections with clients who may be in quarantine.
Best Practice, Policies and Procedures
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Guidelines and Recommendations
Best Practice Recommendations - Needle Distribution
This information sheet helps to address questions about the effectiveness of needle distribution and safe needle disposal.
Best Practice Recommendations - Safe Needle Disposal
This information sheet outlines how to safely dispose of needles.
Best Practice Recommendations - Community Needle Stick Injuries
This information sheet outlines the risks of community needle stick injuries and what to do if a needle stick injury occurs.
Reference Document - Needle Distribution, Disposal and Injury Best Practices
This document provides references to support the information sheets above related to needle distribution, safe needle disposal and community needle stick injuries.
Guidelines for Providing HR Services to Mature Minors in BC
Guidelines for providing HR services to mature minors in BC as per Appendix 2 of the HRSS Guidelines. Last updated December 2014.
BCCDC Opioid Overdose Response Toolkit (Dec 2020)
The opioid overdose response toolkit is intended for all service providers, including regulated and non-regulated service providers and paramedics, who are responding to opioid overdoses across British Columbia (BC). This toolkit does not replace workplace or employer overdose response (e.g., naloxone) policies and procedures; and does not apply to naloxone dispensation.
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Overdose Prevention Sites
Best Practice Recommendations for Overdose Prevention at Meetings and Events
This document provides guidance about implementing temporary Overdose Prevention Services (OPS) at onsite meetings or events where attendees may use substances and be at risk of overdose.
Washroom Checklist in Service Settings
This document provides guidance for service providers to develop safer washroom policies and protocols with a focus on overdose prevention.
Housing Overdose Prevention Site Manual
Housing Overdose Prevention Site (HOPS) Manual developed by Vancouver Coastal Health - 2018 edition.
Engaging in Overdose Prevention Conversations
Developed by Fraser Health, this resources provides some key considerations regarding conversations about overdose prevention.
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Communicating Drug Alerts
Communicating Drug Alerts
Health service providers communicate drug alerts when there is evidence to suggest an adulterated drug or drug of elevated potency is in circulation.
For futher information about communicating drug alerts, visit the BCCDC website.
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Peer Engagement
Peer Work Community Research Report
Findings and recommendations from BC's Peer Engagement and Evaluation Project.
Peer Hiring Meeting Report 2019
The purpose of the peer hiring meeting was to gather feedback and input from peers, harm reduction coordinators and other health authority staff about the hiring of Indigenous Regional Peer Coordinators in each health authority to engage and support existing and emerging peer networks within their regions. This report highlights specific calls to action from the Truth and Reconcilliation Commision Report.
Paying Peers in Community Based Work
An overview of considerations for equitable compensation. Created in partnership with the Paying Peers Working Group - February 2018
Presentation: Peer Engagement in Harm Reduction
Peer Engagement in Harm Reduction: Development, implementation & evaluation of the Peer Engagement Best Practice Guidelines for BC Health Authorities.
Compassionate Engagement Modules
The Compassionate Engagement Modules are a series of interactive case studies about stigma and discrimination experienced by People Who Use Drugs (PWUD). These modules are designed to engage PWUD and the people who provide services to them (health care providers, frontline service providers, managers, and leadership). It works best when there are both PWUD and providers together.
HOC Resolution: Increasing Compassion & Inclusion in Harm Reduction
Health Officer's Council Resolution 145-03: Increasing Compassion and Inclusion in Harm Reduction Services.
There is No Authority but Yourself: Drug User Group Starter Pack
Please refer to https://towardtheheart.com/peer-engagement for a detailed description of this document and its intended use.
Reports and Research
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Research
Research Brief: Meaning and Motivation of Work for Peers in Overdose Response Environments in BC
A research summary on the meaning and motivation of work for peers in overdose response settings based on data from eight focus groups conducted by the Peer2Peer research (November 2020).
Research Brief - Naloxone Distribution in BC and The Role of Community Pharmacies
A research summary on accessing THN in BC and the role of community pharmacies: results from the analysis of adminsitrative data (Sept 2020).
Naloxone Program Evaluations Summary (2019)
A summary from recent program evaluations on the Facility Overdose Response Box Program and the expansion of Take Home Naloxone in community pharmacies (Nov 2019).
Needs Assessment - Gender Affirming Supply Distribution
The intent of this needs assessment was to engage with the wider community to identify what is needed in order to increase access to lower barrier services for no-cost supplies for intramuscular (IM) or subcutaneous (SC) injections. This included ways the BCCDC can improve access to harm reduction supplies and services for the gender diverse, trans, and Two-Spirit communities.
Needs Assessment - Harm Reduction Curriculum
In response to requests from drug user and harm reduction communities across the province, this needs assessment was conducted to gain insight into the educational needs of people working in the field.
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Reports
BC Harm Reduction Client Survey Background and Findings Report (May 2021)
This report provides an overview of background and findings of the BC harm reduction client survey throughout the years.
HRSS Indicators Report 2019 (July 2020)
BC Harm Reduction Strategies and Services (HRSS) Committee Policy Indicators Report including data until December 2019.
THN Evaluation Report - to December 2018
Overdose Recognition and Response in the BC Take Home Naloxone Program.
Review of data up to December 2018Evaluation of THN in Pharmacies
An evaluation of British Columbia's Take Home Naloxone Program in Community Pharmacies
FORB Program Evaluation Report
An evaluation of British Columbia's Facility Overdose Response Box (FORB) program.
Suggested Citation: Williams, S., Lewis-King, T., & Buxton, J.A. (2019). Evaluation of British Columbia’s Facility Overdose Response Box (FORB) Program. Vancouver, BC. BC Centre for Disease Control.
THN Evaluation Report - to July 2016
Overdose Recognition and Response in the BC Take Home Naloxone Program.
Review of data up to July 2016THN Evaluation Report - to March 2015
Overdose Recognition and Response in the BC Take Home Naloxone Program.
Review of data up to March 2015
Updates for Health Professionals
