Virtual Substance Use & Psychiatry Service | Harm Reduction Sites & Services | Naloxone | Lifeguard App | Toward the Heart | Being Safe | Drug Checking | Opioid Agonist Therapy | Land-based Healing
The First Nations Virtual Substance Use and Psychiatry Service provides individuals with access to specialists in addictions medicine and psychiatry. For more about the service as well as an introductory video, see the Virtual Substance Use and Psychiatry Service page.
Harm Reduction Sites & Services
Harm reduction sites and services are the best option for using substances safely during the pandemic. Overdose prevention sites and safe consumption sites are open and safe. Sites are following COVID-19 safety protocols and many have returned to their usual operating hours.
First Nations funded treatment centresMap of Locations offering Harm Reduction Programs in BC
Dozens of overdose prevention sites (OPS) and supervised consumption sites (SCS) operate across BC. These sites provide a hygienic environment where people can consume drugs under the supervision of healthcare workers or peers without fear of being arrested. OPS and SCS sites reduce drug-related harms such as overdose, infection and death. Over 120 of these sites operate around the world without a single fatal overdose recorded.
OPS and SCS sites provide: harm reduction supplies (such as sterile rigs/syringes, stems/pipes, water, ties, swabs); a comfortable place to consume drugs; nurses or trained individuals and naloxone in case of an overdose; a “chill-out” space; education about safe injection techniques, and referrals to different health and social services.
Harm reduction service locations by region:
Fraser Salish InteriorNorthernVancouver IslandVancouver Coastal
Because it has not been possible to establish overdose prevention sites in every community, BC has also created a new “episodic” OPS service, called eOPS. eOPS is a less formal overdose prevention service offered in healthcare and social service settings where health and other trained professionals can support people who use substances. The eOPS program is new in BC, and is expanding in each health region but is not widely available yet.
At participating health facilities, in supportive housing and through other social services, staff may be able to:
Observe or check in while someone consumes drugs on siteProvide harm reduction suppliesPrevent an overdose with NaloxoneEducate about safer injection techniques Offer pharmaceutical alternatives to street drugs in some cases
Naloxone is an injectable medication that can save loved ones from dying of a drug overdose because it reverses the effects of an overdose from opioid drugs.
Naloxone has been added as a First Nations Health Benefis. It is an open benefit in its drug benefit list, which means that it does not require a prescription from a doctor or nurse practitioner.
To obtain naloxone from a pharmacy, you now have two choices and both are covered by First Nations Health Benefits.
You can speak with your pharmacist. If Naloxone is right for you then the pharmacist will provide you with it.
Alternatively, you can visit your doctor and ask for a prescription and have the prescription filled at the pharmacy.
Naloxone is available at pharmacies and at harm reduction service locations (First Nations and provincial), see Find a Site on Toward the Heart.
Intramuscular and Nasal Naloxone Comparison (chart)Nasal Naloxone SAVE ME Steps Summary (video)Naloxone S.A.V.E. M.E.: Steps to Save a Life (video)How to Use Naloxone: 3 minute version (video)Naloxone Saves Lives (video)Naloxone Wakes You Up (video)Overdose death can be prevented: Take-home naloxone kits reverse overdose and save lives (poster)
Nasal Naloxone Access through First Nations Health Benefits (video)Nasal Naloxone (Narcan®) now available at no cost to BC First Nations (fact sheet)
The Lifeguard App can prevent overdose. Ninety per cent of overdose deaths happen when people use substances alone. The Lifeguard app is a digital tool that connects emergency responders automatically to people who are alone and may have unintentionally overdosed. The app is especially helpful if you live in an urban area, have a smartphone, and have access to cellular service or wifi. The app will probably not be as useful in rural and remote areas as emergency responders can take longer to arrive due to the greater distances that they need to travel.
How does the app work? When someone is about to use drugs, they open the app and record the type of substance they are using and confirm their location. The app will hold this information and a timer is set. When the timer ends, the app will sound an alarm, flash a light, and vibrate. The user must hit a button to stop the alarm and indicate they are fine. If they are unable to stop the alarm, a text-to-voice call will go straight to 9-1-1, alerting emergency medical dispatchers of a possible overdose.
The Lifeguard App can be downloaded for free to your smartphone or tablet through the Apple App Store and Google Play Store.
Toward the Heart is a the Harm Reduction program of the BC Centre for Disease Control. Their site is a comprehensive collection of overdose prevention and harm reduction resources, in particular:
Find a Harm Reduction site in your area (province-wide search tool and map)Know Your Source: FentanylOverdose Recognition & ResponseNaloxone Saves Lives
Don’t Let this Be Your Last Party When You’re in Recovery and a Pandemic HitsTips for Safer Celebrating over the Holidays
Check your drugs if there is a site near you. Drug checking is a way to test your drugs for potentially toxic or unexpected substances that could result in overdose or death. A negative test, however, does not guarantee that your drugs are safe because drug checking is not 100 per cent accurate. Even when you have checked your drugs, it’s still essential to carry naloxone, not to use alone, and to start low and go slow.
Highly toxic drugs are circulating and dangerous drugs like fentanyl and benzodiazepines (benzos) are contaminating most street drugs. Toxic amounts of fentanyl have been found not only in opioids but also in stimulants such as cocaine and crystal methamphetamine. Fentanyl and benzos could be in your drugs even if you trust your dealer. There are two ways to test your drugs in BC.
An FTIR machine identifies the presence of substances such as opioids (e.g., fentanyl, heroin), stimulants (e.g., cocaine, crystal meth), and MDMA. FTIR testing is often only available at Overdose Prevention Sites (OPS) or Safe Consumption Sites (SCS) because the machine is large and a technician needs to operate it and interpret the results.
Fentanyl test strips check your drugs for toxic and unexpected substances. Fentanyl test strips are available at all OPS and SCS sites in BC and you can also use the them at home. The test strip is dipped into a mixture of 30 ml of water and a tiny amount of the drug and it only takes a few seconds to get results.
Remember that fentanyl test strips are not 100 per cent accurate and may not detect all toxic substances. Even if you test is negative, the drug may contain fentanyl because the fentanyl might be randomly distributed within the substance (i.e. pill). Although the portion tested may not have fentanyl, this does not mean that your next dose will also be free of fentanyl. The remaining substance may still contain fentanyl, even if the drugs come from the same “batch” or the same dealer.
Fentanyl test strips can detect fentanyl and some variations of fentanyl, but not all. Unfortunately, the strips may not detect other substances, such as carfentanil and other drugs similar to fentanyl.
Drug Checking (and fentanyl test strips) (Vancouver Coastal Health)Drug Checking with Fentanyl Test Strips (Interior Health; search using this term)
Opioid Agonist Therapy
Opioid use disorder is a medical condition that can be treated with opioid agonist therapy (OAT). OAT is a safe option for substance use and is part of a continuum of harm reduction services. OAT is an effective treatment for people dependent on different types of opioids such as heroin, oxycodone, hydromorphone (Dilaudid), fentanyl and Percocet. The therapy involves taking opioid agonist medication, either methadone (Methadose) or buprenorphine (Suboxone). These medications work to prevent withdrawal and reduce cravings for opioid drugs. For people experiencing addiction to opioids, OAT can be a helpful part of their healing journey. For more information on how to access OAT and to review Frequently Asked Questions, see Opioid Agonist Therapy.
Read about Dwayne & Trish's personal journeys with OAT – Part 1 and Part 2.
Land-based healing is a process to heal the heart by connecting with First Nations traditional ways and teachings as people cope with trauma, grief, and loss. Land-based healing creates connection to the land and the traditional life-skills of hunting, fishing, trapping and outdoor survival. This type of healing supports people along their healing journey by offering skills, knowledge and connection with the land through culture, language, traditional teachings and ceremonies.Land-based healing helps people of all ages learn to cope, heal and, ultimately, to live life by building on the traditional practice of passing on skills and knowledge to future generations. The experience supports healing and growth on all four corners of the medicine wheel and enhances emotional, physical, mental and spiritual health.Supporting Land-based Healing during the Pandemic (news story)Connecting to the Land restores and empowers (news story)Leading with an Open Heart (news story)
BC Drug & Poison Info Centre (Anonymous Non-Emergency Assistance): 1-800-567-8911
Healthlink BC: 811
This material may trigger unpleasant feelings or thoughts. If you need emotional support, please contact the 24-hour
KUU-US Crisis Line: 1-800-588-8717
KUU-US Crisis Response Services (poster)