Providence Health Care (PHC) Division of Addiction and the BC Centre on Substance Use (BCCSU) have co-developed the Road to Recovery (R2R) Initiative – an innovative new model to transform substance use care in BC. The initiative will focus on providing a full continuum of substance use care at St Paul’s Hospital.

BC continues to grapple with the toxic drug poisoning public health emergency, with almost 2,300 deaths from poisoned drugs in 2022.

Amid this crisis, demand for substance use services – from detox to recovery – is greater than ever. At St. Paul’s Hospital in Vancouver alone, one in six inpatients has an addiction. Requests for an addiction medicine consultation by emergency doctors or other hospital care providers at St. Paul’s Hospital have increased by almost 230% in just five years, from 1,373 in 2013 to 4,507 in 2018. Over 15,000 patients have needed and received care at the hospital’s Rapid Access Addiction Clinic (RAAC) since opening its doors in 2016.

A major challenge for people with an addiction is timely access to safe and appropriate recovery services. Currently, there are long wait lists for publicly funded beds and a shortage of evidence-based recovery care. Gaps between early treatment and recovery can mean a failure to connect people to supports when they need them most.

The Road to Recovery (R2R) initiative is a multi-year phased approach to scale-up and expand addiction services starting at the current St. Paul’s Hospital to ensure care meets demand and makes recovery from addiction possible. This is initiative was made possible by a founding gift from the Diamond Foundation and financial support from the Province of BC.

These investments will create 25 acute stabilization and withdrawal management beds, and 20 transitional stay beds at the current St. Paul’s Hospital, all of which will be relocated to the hospital’s new campus when it opens in 2027. An additional 50 PHC recovery beds will be created in the community in close proximity.

Through the R2R, people who come to St Paul’s Hospital seeking addiction treatment will have access to a comprehensive, full range of evidence-based and culturally safe early recovery interventions including withdrawal management, stabilization care, transitional care, and long-term recovery services. Referrals for care will be coordinated and transitions between addiction services will seamlessly support individuals at every phase of their recovery journey.

Intake and access to addiction services will be centralized and referral pathways between treatment providers coordinated, which will ensure the system of care to support individuals with an addiction is streamlined, easy to navigate, and provides the appropriate type and level of support needed over time to patients and their families.

Data collection will be integrated as a part of the R2R so as to transform how high-quality, evidence-based addiction care is delivered.

In addition to co-developing the vision for R2R, the BCCSU will:

• • Ensure standardized practice supports and protocols are in place;
  • Train health professionals to ensure the highest quality of care is delivered; and
  • Conduct and create a comprehensive research and evaluation program – with the intention to recruit and retain research scientists in partnership with the University of British Columbia – to ensure that the findings of this groundbreaking program are shared in order to serve as a model provincially, nationally, and internationally.

The primary objectives of research and evaluation of R2R are to:

• • Describe and evaluate the implementation of R2R services, focusing on development, adaptation, progress, and functionality.
  • Evaluate health and social outcomes among people who access any R2R service, including substance use trends, quality of life, and health care utilization patterns such as ED visits and hospital admissions
  • Capture patient experiences and satisfaction with R2R services, identify opportunities for improvement, and understand how access to these new services impacts a patient’s addiction treatment trajectory.

Beyond increasing local addiction treatment capacity, the Road to Recovery initiative will also bring together key partners including Providence Health Care and its Indigenous Wellness and Reconciliation Team, Vancouver Coastal Health's  Regional Addiction Program, the BC Centre on Substance Use, the University of British Columbia and individuals with lived and living experience and their families to undertake a regional health system redesign.