The Peterborough 360 Degree Nurse Practitioner-Led Clinic is proud to be taking the lead on an important project developing a safer supply program suitable for our small urban/rural community. Safer Supply enables people who use drugs to access regulated substances from a legal source and this saves lives. Our clinic’s vision is a community where all people have access to high-quality primary healthcare and an equal opportunity to be healthy – Safer Supply is one of the ways that we can reach this vision.
What: Safer Supply Research Project: “Embedding Safer Supply Prescribing in Primary Care Teams in a Small Urban Community: Exploring Enablers and Barriers”
Who: Peterborough 360 Degree Nurse Practitioner-Led Clinic is the lead organization, in partnership with the Trent/Fleming School of Nursing
Where: Peterborough. Successful models exist in larger urban centres such as London. Toronto, and Ottawa.
When: April 2021-June 2023 (27 months).
1st year: Research with prescribers, pharmacists, addictions treatment providers, harm reduction professionals and people who use drugs to work with us to develop a model of safer supply that can work for Peterborough.
2nd year: A small pilot safer supply program with 10 participants and evaluation to review the outcomes for participants, providers, and the community, refine our local approach, and share knowledge about how the promising practice of safer supply projects might be offered in other smaller communities across Canada.
Why: Safer supply is part of a broader response to the overdose crisis and will increase the options people who use drugs have to treatment. It offers the opportunity to engage clients in a new, innovative, and positive manner – many of whom have not been connected to health care or any other services.
“I’m very pleased to see the support given to this study to determine how a safe supply can work in our smaller urban centre to save lives. The pandemic has only intensified the local opioid crisis, so we urgently need this data to guide our efforts to know which interventions are effective.”
Dr. Rosana Salvaterra, Medical Officer of Health, Peterborough Public Health
“Peterborough Police Service is happy to support our partner, Peterborough 360 Degree Nurse Practitioner-Led Clinic with the new project they are leading through Health Canada. The Safer Supply Project will be another tool in the toolbox for assisting community members with addictions.”
Chief Scott Gilbert, Peterborough Police Service
“The Trent Fleming School Nursing’s vision is to be a driver of social justice improving the health and quality of life for marginalized populations through research, teaching and community partnerships. We look forward to supporting this research project to explore Safer Supply as an innovative practice to reduce the harms of illegal opioids and engage marginalized individuals in health care.”
Kirsten Woodend, Dean, Trent/Fleming School of Nursing
SAFER SUPPLY FAQ
- Why is Safer Supply necessary?
Ontario is in the midst of a devastating overdose crisis and has seen a 60% increase in the number of opioid-related deaths in the past year. In 2020 there were 2,426 opioid-related deaths, compared to 1,516 opioid-related deaths in 2019 (information from the Office of the Chief Coroner, 2021).
In 2020, Opioid-related emergency room visits in Peterborough were nearly double that of the province, and in the first 4 months of 2021, there have already been 20 suspected opioid-related deaths in our community (information from Peterborough Public Health, 2021). The overdose crisis is driven by the presence of unregulated fentanyl in the street-acquired opioid supply. Currently in Ontario, fentanyl is responsible for 86% of all opioid-related deaths (information from the Office of the Chief Coroner, 2021). The worsening of the overdose crisis during COVID-19 has been documented across Canada, and there is no sign that this tragic crisis will end soon.
These numbers are not just statistics. Each of these deaths is a loss of a person who is loved and cherished as a member of our community and there is an indescribable amount of grief and loss being experienced in our community due to these overdose deaths. A comprehensive response to this crisis is needed. Safer Supply programs are one element of this response and are currently being piloted across the country in an attempt to reduce overdose deaths.
- What is a Safer Supply Program?
Safer Supply Programs are an extension of the traditional harm reduction model which is offered to high-risk populations who use street-acquired substances. It focuses on a client-centred, team-based, and comprehensive approach to meet the needs of the person accessing services. These models have sometimes followed the community health centre model of care or can be achieved by being integrated into primary care clinics in close partnership with harm reduction organizations. This allows for comprehensive wraparound services and care to be offered to clients.
As part of safer supply programs, physicians and nurse practitioners carefully assess all patients, and for people who qualify, they prescribe pharmaceutical opioids to clients to replace the fentanyl from the street-acquired supply they have been relying on. The comprehensive harm reduction model creates stability for clients as they embark on a path to greater health and wellness. In addition, a peer advisory committee and peer mentorship are key elements of this program.
- What will the Safer Supply Research Project look like in Peterborough?
The Peterborough 360 Degree Nurse Practitioner-Led Clinic intends to collaborate with a broad range of community partners in developing and piloting this program.
The first year of the Safer Supply Project will be research focused. We will be talking to people who use drugs locally and service providers both locally and in organizations that have already established Safer Supply Programs. We want to learn about the barriers and enablers to both traditional treatment models and Safer Supply Program models so that we can build a program that meets the specific needs of people who use drugs in our small urban and rural community.
Upon completion of this research, our goal is to begin a small-scale Safer Supply Pilot Program for clients that meet certain criteria. This program will include an extensive evaluation component that looks at the impacts of the program both on individual and community outcomes measures. We want to learn from the process so that we can see what the potential is for scaling up the program in a small urban and rural community like Peterborough. This safer supply project will be part of a broader response to the overdose crisis and will increase the access people who use drugs have to a broad range of treatment options.
- Why should we care about Safer Supply Programs?
The right to health care is a basic human right. We have strong evidence that people who use drugs frequently face stigma and discrimination when they attempt to access healthcare services. Safer Supply programs are one way of trying to engage people who use drugs in low-barrier healthcare services. The lack of meaningful inclusion in health care, social services, and community participation has been directly related to the stigmatization and criminalization of drugs and the people who use them. Through Safer Supply programs, we are able to engage clients in a new, innovative, and positive manner.
- Who is funding this research project in Peterborough?
This 27-month Safer Supply Project is funded by Health Canada’s Substance Use and Addictions Program (SUAP). Generally, the cost of medication for participants on the pilot program is covered by provincial drug plan benefits.
- What are early results suggesting from Safer Supply Programs in other Canadian communities?
- Increased engagement in primary care à improved physical and mental health
- Increased referrals to specialist care
- Increased engagement in HIV and Hepatitis C treatment
- Increased engagement in social support, counselling, and employment support
- Increased engagement in harm reduction and peer support
- Reduction in overdoses and overdose deaths
- Reduction in fentanyl exposure
- Reduction in Intravenous drug use
- Reduction in infections
- Reduction in hospital admissions and emergency room visits
- Overall reduction in health care costs
- Reduction in homelessness
- Reduction in sex work
- Reduction in criminal activity
- Reduction in incarceration
- Overall reduction in costs related to crime and incarceration
