Substance use care in rural and remote contexts

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Summary

The overdose crisis is affecting all parts of the country, but the majority of research has focused on major cities, and the majority of services are located there too. In this episode of Addiction Practice Pod, Dr. Robert Fox talks with guests about substance use care in rural and remote contexts.
 

Lineup

In this episode, you’ll hear:

• 2:30 – Kate Hodgson – Nursing Practice Consultant at First Nations Health Authority*
• 12:30 – Dr. Geoff Bardwell – Research Scientist at the British Columbia Centre on Substance Use
• 18:40 – Jesse Whelan – Harm Reduction Counsellor and Supervised Consumption Site Team Lead with Blood Ties Four Directions Centre

 
Pearls

Here’s what listeners can take away from this episode:

1. Exploring opportunities to provide care virtually, for example through video consultations, may address geographic barriers and allow more anonymity when accessing substance use care in rural and remote settings.
2. People who use drugs often experienced stigma and discrimination when accessing care. Negative interactions can be even more impactful for patients in rural and remote locations because they have fewer options when it comes to care providers. Building trust with our patients and fostering cultural safety in our clinics can help reduce barriers and make people feel more comfortable.
3. Providing care for people who use drugs in remote and rural contexts often means working with fewer resources than those available in urban centers. Supports that people can have at home, including take-home naloxone and the Lifeguard app are important tools in preventing overdose.

 
Resources

De-centring western colonial approaches

• Addiction Practice Pod, S1 Ep6: Indigenous perspectives on health and wellness, substance use and harm reduction
• First Nations treatment centres in BC (map)
• Rural and Indigenous Overdose Action Exchange. 2019 (report)

Online learning

• BCCSU’s Provincial Opioid Addiction Treatment Support Program (Online, self-paced, free)— See Unit 22, Treating Opioid Use Disorder (rural context)

Articles

• Bardwell, G., & Lappalainen, L. (2021). The need to prioritize research, policy, and practice to address the overdose epidemic in smaller settings in Canada. Canadian journal of public health = Revue canadienne de sante publique, 112(4), 733–736.
• Benavides-Vaello, S., Strode, A., & Sheeran, B. C. (2013). Using technology in the delivery of mental health and substance abuse treatment in rural communities: a review. The journal of behavioral health services & research, 40(1), 111–120.
• Mema, S.C., Frosst, G., Bridgeman, J. et al. Mobile supervised consumption services in Rural British Columbia: lessons learned. Harm Reduct J 16, 4 (2019).
• Kornelsen, K., Carthew, C., & Lloyd-Kuzik, N. (2012). Understanding Outpatient Substance Use Treatment for British Columbia’s Rural and Remote First Nations. Visions Journal, 16(1), 8.
• Parker, J., Jackson, L., Dykeman, M., Gahagan, J., Karabanow, J. (2012) Access to harm reduction services in Atlantic Canada: Implications for non-urban residents who inject drugs, Health & Place, volume 18, issue 2, pages 152-162, ISSN 1353-8292

Additional resources

• Holding Hope and Healing Hearts, support groups offered by Moms Stop the Harm for families and loved ones in many locations.
• Don’t Be an A**hole: best practices for health and social care providers working with people who use drugs. 2018. Produced by Blood Ties Four Directions Centre

• Nurse Prescribing: A Community Conversation, presented by First Nations Health Authority and BC Centre on Substance Use

 
* Kate Hodgson works with FNHA’s Four Directions team. In doing this work, she acknowledges that she is a White settler and lives as a humble guest on the traditional territory of the Tla’amin Nation peoples.