Data from safer-supply intervention programs run by a clinic in Peterborough, Ont., show a major reduction in overdoses and less drug use for its participants.
In 2022, the Peterborough 360 Degree Nurse Practitioner-Led Clinic (360 NPLC) launched safer-supply programs (SSP, or prescribed alternatives programming) as a means to provide a safer alternative to “toxic and unpredictable” street drugs. The program is one of 25 pilots funded by Health Canada’s Substance Use and Additions Program.
As of May 2024 there were 41 participants in the program. They are individuals deemed most at risk of a drug overdose or death. They are prescribed a regulated, pharmaceutical-grade opioid (Dilaudid tablets) which can be swallowed, inhaled or injected.
The clinic on Thursday released the results of interviews with participants in its programs encompassing May 2022 to December 2023. A round of interviews in November 2022 involved 14 of 21 participants; another round of interviews in January 2024 involved 16 of 41 program participants.
The report says participants reported 79 per cent fewer overdoses in the last six months compared to the first six months of program enrolment.
With the exception of one participant who transferred from another SSP, all program participants were using fentanyl when they starting their SSP.
Approximately 86 per cent of individuals reported using less or no fentanyl after 12 months in the SSP — 43 per cent reported a reduction and another 43 per cent reported being fentanyl abstinent.
“Of participants exclusively injecting fentanyl at enrolment we saw a 50 per cent reduction in injecting by 12 months,” the report states.
The report notes that at intake 73 per cent of individuals had visited an emergency department in the previous four months for a drug-related issue. After 12 months of programming, this had dropped to 31 per cent.
Nearly 80 per cent of participants received counselling for mental health issues and nearly 70 per cent indicated that their mental health had improved after a year in the program.
Just over 70 per cent of participants who spent a year in the program also reported a decrease in criminal activities such as sex work, selling drugs and theft.
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Kelly Pensom, 360 NPLC nurse practitioner lead and clinical director, said its SSP is producing positive results for individuals.
“This program has highlighted the positive impacts on the health and well-being of people who use drugs when their care is embedded within a destigmatized primary care team dedicated to trauma informed harm reduction in the delivery of its services,” she said.
Also, in tackling their addictions, nearly 95 per cent of individuals were screened for health issues. The report says 75 per cent of participants indicated that their physical health had improved after 12 months in the program. Just over 65 per cent had received preventive vaccines and nearly 50 per cent were connected to specialist care.
“The findings clearly indicate the clinic’s safer-supply program has been a success in Peterborough in a number of ways to help save lives, reduce the use of illicit (unregulated) drugs, and connect marginalized community members to primary healthcare,” said Carolyn Kin, safer supply program coordinator.
Between January and December 2023, Peterborough Public Health reported 78 opioid related deaths, 377 emergency service calls for drug poisonings, and 424 emergency department visits for drug poisonings in the Peterborough area.
So far in 2024 to end of May, there have been 31 suspected drug-related deaths and 184 emergency visits for drug poisonings, according to the health unit’s opioid harms data portal.
Dr. Thomas Piggott, the health unit’s medical officer of health, says the pilot project is a key step to helping address the area’s opioid crisis.
“It is wonderful that this life-saving program diverting people away from a toxic supply of street drugs in Peterborough has been effectively connecting people to supports and health care and that the pilot has contributed to the growing body of evidence for the benefits of prescribed safer alternatives in Canada,” he said.
The report notes 45 per cent of participants interviewed were between the age of 30 to 39. Of the participants, 61 per cent were men. Eighty per cent of participants had reported experiencing homelessness for at least one night in the last four months.
The report recommends further funding and supports for safer-supply programs and to “scale up” to meet community needs.
“The development of safer stimulant supply should also be considered,” the report concludes. “While recognizing that safer supply is only one of a range of productive responses to the drug-toxicity crisis, the growing evidence supports the efficacy and validity of SSPs.”
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