Peers are the experts in their own experience and provide important perspectives and a reality check.
A peer can be defined as a person with equal standing in a community who share a common lived experience1. Peers use their lived experience with substance use in their professional work.
Peer engagement uses a community based approach to decision making, as engaging the community in the process is far more likely to lead to effective and acceptable service delivery. However, in practice peers are often underutilized in the prevention of substance use related harms2 and peer engagement efforts involve sharing information only and therefore can be considered merely tokenism.
Peer engagement can address equity of harm reduction services and interventions by fostering communication, building trust, increasing knowledge, and reducing stigma and discrimination to remove barriers and increase utilization of services.
Engaging people with drug use experience in policy development, research, programming, and practice is necessary to ensure interventions and harm reduction services are relevant and acceptable.
- Ti L,Tzemis D, Buxton JA. Peer engagement in the context of policy and program development: A review of the literature Substance Abuse Treatment, Prevention, and Policy (2012) 7:47 http://www.substanceabusepolicy.com/content/7/1/47
- Marshall Z, Dechman MK, Minichiello Alcock AL, Harris GE, “Peering into the literature: A systematic review of the roles of people who inject drugs in harm reduction initiatives,” Drug Alcohol Depend 151 (0), pp. 1–14, 2015
Dual Public Health Emergencies in BC
We are in the midst of a dual public health emergency in BC. Peers/experiential workers have been at the forefront of the opioid crisis over the last 4 years.
Below are resources for experiential workers:
Finalized May 14th, 2020
Covid-19 Support Guide for Vulnerable Individuals in BC (Updated biweekly)
Last Update: May 19th, 2020
The Peer to Peer (P2P) Project
Experiential Workers, or peer workers with lived/living experience, are important service providers that play a crucial role in supporting individuals that use substances in overdose response situations. These situations are stressful and can have lasting social, mental and emotional impacts for Experiential Workers. Unlike other healthcare providers and first responders, Experiential Workers often lack access to institutional or occupational mental health support.
The Peer2Peer (P2P) project aims to identify, implement and evaluate peer-led support interventions that would be valuable and effective for Experiential Workers.
Eight peer-led focus groups (needs assessments) were conducted between November 2018 and March 2019 across the lower mainland and Vancouver Island. Three major themes were identified from the needs assessment and formed the basis of the intervention model, “ROSE”; R-Recognition, O-Organizational Support, S-Skill Development, and E-for Everyone. Implementation of this intervention is currently being piloted at two organizations: RainCity Housing in Vancouver and Fraser regions, and Solid Outreach in Victoria.
The video below summarizes the P2P project and the key components of the ROSE model. This video was submitted and shortlisted for the University of Victoria’s Research Reels video contest (aimed at highlighting cutting edge research happening at the university).
To increase recognition for the crucial work done by experiential workers in overdose response settings, a video featuring ‘a day in the life of a peer’ has been developed. This video highlights stories of experiential workers’ lived experience within communities that use substances.
'Peers' - A song written by Tracy Scott and Kat Wahamaa
Templates for Other Organizations
The ROSE model can be implemented by organizations across Canada to better support experiential workers in their roles. Here are some documents created by experiential workers that can be tailored and implemented at different organizations:
There is No Authority but Yourself
BCCDC’s Reader and Guide to Drug User Self Determination and Organizing
There Is No Authority but Yourself is a compilation of various resource documents into one extensive reader with the primary focus being on organizing as a drug user group. Topics included are: harm reduction 101; decolonization and harm reduction; how to register as a harm reduction supply distribution site; opiate overdoses, naloxone, and how to register as a Take Home Naloxone site; how to run a pop-up overdose prevention service site (both injection and inhalation); tools for running a drug user group (including how to register as a society); income clawback exemption information; information on the mental health act; and information on safe supply.
This document is living, meaning that some of the information may need revisions or may not be totally up to date. If there are corrections that need to be made, please email email@example.com.
Compassion, Inclusion & Engagement (CIE)
The Compassion, Inclusion and Engagement initiative (CIE) is a provincial collaboration between FNHA and BCCDC that works closely with regional Health Authorities to support innovative local improvements in harm reduction service. CIE facilitates community based dialogues across BC that provide opportunities to build capacity and develop networks across and within health services and community agencies to foster and promote accessible, inclusive and culturally safe harm reduction services through ongoing peer engagement.
CIE recognizes that some people experience multiple barriers when accessing services such as racism, poverty, and concurrent mental health and substance use issues and is working to address these by supporting equitable and culturally safe processes and practices. With leadership support, engaging people who use harm reduction services and their network of peers in service design, delivery and evaluation has been identified as an effective strategy to address stigma and discrimination by building respectful relationships and shared understanding. Through the engagement process, CIE has learned that harm reduction services built on trust, respect, understanding and acceptance provide a safe and welcoming environment where people who use drugs are accessing harm reduction supplies and services most often.
CIE Semi-annual Reports
Peer Engagement and Evaluation Project (PEEP)
The Peer Engagement and Evaluation Project (PEEP) is an innovative initiative to ensure everyone across the province has access to harm reduction services.
PEEP Consultation and Advisory Board
Previously the Peer Engagement and Evaluation Project, the PEEP Consultation and Advisory Board is continuing their work as Provincial consultants to inform and advise on harm reduction services and peer initiatives including, but not limited to, harm reduction policies and documentation.
The goal of the PEEP Consultation and Advisory Board is to inform and enhanced peer engagement with best practice recommendations so service providers BC-wide can work with peers in their communities to better meet local needs. This board builds on existing peer relationships and explores new ways for more meaningful, ongoing dialogue with service providers and community partners.