Gina* is a tall, pretty young woman. Her hands, like much of her arms, are covered in ink. Her long hair is a shock of dreadlocks and her voice is not much louder than a whisper. But she is articulate and self-possessed and when she speaks, you lean in and listen. Today she is speaking about her health troubles, her drug addiction, and how the injectable opioid agonist treatment clinic, or iOAT, has helped. “The first month was really tough,” she says. There is a hint of pride in her voice. She has been attending the clinic regularly since it opened in April 2019. “I’ve had people stop me and ask me what I’m doing differently, because I’m looking good. People at the shelter where I’m living think I work there. They think I’m a staff person,” she says. She goes on to describe her volunteer work in the community. It’s clear that she enjoys helping others. “Our injectable patients are really making dramatic recoveries, even though it’s early days,” says Dr. Megan Hill who runs the iOAT clinic. “We have had remarkable retention in the program since it started.” The retention of clients is impressive because iOAT is a major commitment for people who typically have little stability in their lives. Clients need to attend three appointments each and every day to receive their medication. It is an obligation that they find worthwhile in order to receive medicine via injection in a safe, sanitary environment. The program can mean an end to the panic and chaos of street drug dependence. “You get tired of the constant hustling and theft. The lies. That’s not who you are,” explains John*. “I don’t do that anymore. Best decision of my life.” John has also been attending the iOAT clinic since it opened. He admits he is addicted to needles – not uncommon with severe opioid addiction – but he is also deeply concerned about the street drug supply, what is in the drugs, and how it’s impacting his health. The iOAT clinic, he says, is a “10 out of 10” compared to other treatments he has tried. “I’ve been to detox …” he pauses as if to count. “More times than I could even say,” he concludes. Dr. Hill recalls one patient who told her ‘you guys care so much about my health that I decided I should too, and now I'm getting better.’ Another patient said, ‘I didn't think things could be good, but now they're starting to be good and I can address more problems than just my addiction.’ “Both have horrifying medical issues that have been completely unaddressed until now and it's hard to believe they've been living with them for so long,” says Dr. Hill. The medication injected is called Hydromorphone. It is an opioid commonly used to treat moderate to severe acute pain. It helps with cravings for illicit opioids and prevents overdoses, as well as preventing debilitating opioid withdrawal, which is usually the reason people continue to use fentanyl or heroin. The clinic also provides a regular connection with a health-care team, including physicians, nurses, pharmacists, and social program officers, which can help with overall stabilization. For now John continues to take it a day at a time, spreading the word about the clinic and putting on weight. “Because I’m living the good life,” he says, patting his stomach with a smile. *Patient names changed to protect privacy

It's being called ground-breaking work. A small and mighty team of Interior Health physicians and nurse practitioners are going above and beyond in supporting some of the region’s most vulnerable populations during the COVID-19 pandemic. The devoted group are supporting people who are impacted by the poisoned drug supply crisis and have to isolate due to a positive COVID-19 test, by meeting them where they are. An initiative led by the Mental Health and Substance Use Network brought together the group of health-care professionals who are providing coverage seven days a week to ensure people across the region have access to prescribed safer supply when needing to isolate. “It is clear by the increasing death rates across the province that the drug supply has become even more toxic,” says Corinne Dolman, Interior Health's Manager of Substance Use Services. “This service is imperative not only to ensure people are able to isolate and reduce the transmission of COVID-19 but also to prevent high risk withdrawal from substances.” The program has already worked with people in Vernon, Penticton, Trail, Kamloops and other parts of the region who may be at increased risk of overdose, withdrawal, cravings and other harms related to substance use. “This vulnerable population has suffered increased isolation and stigma throughout the pandemic. The hard work and efforts to provide prescribed safer supply and other treatment medications has truly made all the difference. We have been able to reach this at-risk group and create connections for ongoing support that many did not have before,” says Pam Ruby, Interior Health’s Regional Pandemic Health Coordinator. The program will continue until December 31, 2021. “This is an innovative strategy that allows the vulnerable population to isolate with the added benefit of connecting the clients to addictions and harm reduction services across the entire region. This reduces barriers to care allowing the vulnerable population access to this much needed service. This is a ground-breaking innovation,” said Brent Hobbs, MHSU Network Director for Pandemic Isolation Centres.