Overview

The rate of hospitalization and death due to substance use continues to rise in British Columbia (BC). While reasons for this are multifactorial, the toxic nature of BC’s illicit drug supply combined with the province’s siloed and fragmented addiction treatment system are key contributors. Accordingly, in 2022 the BC Coroners Services’ Death Review Panel and, more recently, BC’s Select Standing Committee on Health have both called urgently for the creation of a coordinated system of substance use care.

PHC in collaboration with BC’s Provincial Ministry of Health (MOH) and Ministry of Mental Health and Addictions (MMHA), Vancouver Coastal Health (VCH), and VCH/Providence Health Care’s Regional Addiction Program (RAP) will be implementing a first-of-its-kind model of addiction care through the Road to Recovery Initiative (R2RI). This initiative will provide a comprehensive continuum of care for individuals seeking treatment for substance use disorders. It will also increase the number of available beds for substance use treatment.

Increased capacity will be accomplished through the operationalization of almost 100 new addiction treatment beds at the current St. Paul’s Hospital (SPH; or in close proximity) over the next 5 years. Furthermore, collaboration with VCH’s community and RAP is well underway to optimize access and coordination to existing clinical addiction services in the region to ensure every individual can access addiction treatment exactly when they may need or want it.

As this new service model unfolds, Dr. Seonaid Nolan and her team will be conducting a health services evaluation and observational study that will follow individuals receiving care through the new service model.

Objectives

1. To describe the demographic and clinical characteristics of individuals who receive care through any R2RI services
2. To monitor the progress of R2RI implementation over time
3. To determine the impact of R2RI service access on health care utilization patterns including characterizing referral and flow patterns within and between R2RI and community
4. To observe treatment trajectories and identify predictors of favorable outcomes
5. To investigate the impact of R2RI service access on substance use patterns and harms relating to ongoing substance use
6. To qualitatively capture patient and provider experience and satisfaction with R2RI services, identify opportunities for improvement, and characterize how R2RI service access may have impacted their own treatment trajectories, health, and well-being

Partners

• Providence Health Care (PHC)
• Vancouver Costal Health (VCH) Regional Addiction Program
• St. Paul’s Foundation
• PHC’s Indigenous Wellness and Reconciliation Team
• University of British Clumbia
• BC Ministry of Health
• BC Ministry of Mental Health and Addictions

Funders

• Diamond Foundation
• Province of British Colombia

Investigator

The R2R Study is led by Dr. Seonaid Nolan, Head, Providence Health Care’s Division of Addiction; Clinician Scientist, BC Centre on Substance Use; Assistant Professor, Dept. Medicine, UBC; and UBC Steven Diamond Professor in Addiction Care Innovation