Canada’s first in-hospital overdose prevention site touts lives saved

Licensed practical nurses supervise St. Paul’s patients as they inject illicit opioids, stimulants

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The first overdose prevention site inside a Canadian acute-care hospital has so far saved dozens of lives.


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But while nurses and support workers who operated the site for the past year in Vancouver celebrated its first anniversary with cookies and balloons Tuesday, they also had thoughts about what more could be done to prevent people dying from B.C.’s toxic drug supply.

“I used to see people who left the hospital to use drugs out in the back parking lot,” said Karen Scott, a peer worker at Providence Health Care’s St. Paul’s Hospital who grappled with heroin addiction for three decades.

Scott, now five years into recovery, escorts patients to the hospital’s own supervised consumption site, in a room on the fourth floor.

“As a patient, you have that fear of ‘I used drugs, they’re not going to accept me back’ but that’s not the case here,” she said.


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Two licensed practical nurses supervise St. Paul’s patients as they inject illicit opioids, including heroin and fentanyl, in private booths during the sites’ hours of operation, 10 a.m. to 8 p.m.

When a patient begins to show signs of overdose, the nurses are ready to intervene with a life-saving drug: naloxone.

The site had 2,300 visitors in the past year — close to 10 a day — a mix of people being treated at the hospital or drop-ins from the community. Of those visits, 90 resulted in overdoses that were reversed by nurses.

“We’ve not seen one overdose death,” said Elizabeth Dogherty, a clinical nurse specialist with Providence Health Care. “We’ve also seen over 1,300 patients come here to pick up sterile supplies to use for smoking and inhalation.”


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Before its inception, RainCity Housing and Vancouver Coastal Health operated a peer-led overdose prevention site in a trailer on the hospital’s parking lot during the provincewide opioid crisis that caused at least 1,782 deaths in 2021.

When the safe consumption site moved to Yaletown in February last year, Providence Health Care rushed to fill the void.

“A bunch of our patients accessed that site,” said Dogherty. “We knew we needed to come up with something super quick to offer that same type of service … we tried to make it as anonymous as we could.”

Upon entering the room, patients are asked to write down their names and their care unit, if being treated in the hospital.

Peer support worker Karen Scott at St. Paul’s Hospital, where its overdose prevention site has marked its first year of operation.
Peer support worker Karen Scott at St. Paul’s Hospital, where its overdose prevention site has marked its first year of operation. Photo by NICK PROCAYLO /PNG

“We don’t tell physicians or nurses in the wards that patients are using the site unless they need some type of medical intervention,” Dogherty said. “We’re trying to prevent them from using alone in bathrooms or stairwells or hiding their use.”


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Though successful, the nurse-led overdose prevention site is facing barriers, Scott and Dogherty said.

When the site opened last February, Scott said uptake was “a little bit slow because if you’re a patient and have addiction problems to start with, it’s hard coming to a place inside a hospital, where you think you might get judged.”

In order to increase the sites’ credibility among drug users, Dogherty hopes that peer workers become more integrated into its medical-care model. Currently, they are able only to serve as escorts to the room, not facilitators of harm reduction services.

“Having a peer here increases that credibility, that safety, that non-judgmental environment,” she said.

The hospital’s overdose prevention site does not have the ability to supervise patients who smoke or inhale their drugs.


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“We don’t have the proper ventilation. My wish is that we could have an inhalation space that is supervised for people smoking opioids or stimulants, we are seeing that with a lot of our patients,” Dogherty said.

“The current drug supply is contaminated with everything, so even people who are using stimulants like cocaine and methamphetamine, there are opiates like fentanyl that are really unsafe for someone who doesn’t have a tolerance.”

The last hurdle to getting more patients using the site has been a lack of awareness about its establishment.

“We learned for opening the site that we needed to do education across the board,” Dogherty said. St. Paul’s nurses handed out postcards to inform patients of the overdose prevention site.

“I’m sure a lot of people don’t know, but patients certainly talk to each other and that increases access to our site.”

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