Theme: Models of Care Year: 2019
Background: In the context of the Canadian opioid overdose crisis, often related to fentanyl,
people who use drugs (PWUD) are at risk and are often missing from the statistics, as many of
them do not use the public health system. The epidemiological surveillance system in Quebec
assesses the presence of fentanyl only when overdoses are lethal, failing to make the link with
this substance during non-fatal overdoses. To prevent these events, the Centre Sida Amitié
(CSA) has developed an Integrated Approach Community Based Drug Testing (IACBDT).
Description of model of care/intervention: IACBDT includes access to community-based
medical and psychosocial services, screening for sexually transmitted and blood-borne
infections (STBBIs), drug testing, naloxone distribution and related training, sterile drug use
equipment, opioid agonist therapy (OAT), as well as group training in the community. The
innovation of this model is based on the detection of street drugs in the urine samples and drug
residues that the PWUD voluntarily provide. A rapid test for fentanyl is done on site and then,
they are sent to the provincial public health laboratory where they are tested for 210
substances.
Effectiveness: 1891 samples have been submitted for drug testing since September 2017. This
community monitoring helps educate and inform PWUD, health workers, community-based
organizations, public health services and the population about substances that circulate locally.
This presentation aims to explain this model and to discuss the results.
Conclusion and next steps: This holistic person-centered approach is successful and is
supported by local law enforcement and public health authorities. Based on a harm reduction
approach, it reaches out to vulnerable and marginalized people to empower them and provides
them with services that meet their needs and thus, act upstream of the opioid overdoses.
Disclosure of Interest Statement: No sponsorship or conflict of interest for this project, but
Centre Sida Amitié receives funding from ViiV Healthcare, Merck and Gilead.