Lessons from Vancouver in healthcare provision for injecting drug users
Published: 12 Oct 2017
Opening medically supervised injection sites for drug users in high risk areas of the UK should be considered urgently, according to a report by Dr Dush Mital, a Consultant Physician from Milton Keynes, who travelled to Canada this summer to investigate healthcare provision for patients living with blood borne viruses (BBVs) due to substance misuse. Dush’s travels were enabled by a Winston Churchill Memorial Trust Travelling Fellowship Award, in partnership with the Royal College of Physicians of Edinburgh.
As a specialist in blood borne viruses, Dush frequently looks after patients who inject drugs. Vancouver’s healthcare providers have had stunning successes engaging with this often-marginalised group, and Dush wanted to use his Fellowship to investigate how this success had been achieved.
During his travels, Dush met with Public Health policy makers, and doctors and nurses administering care in hospital and clinic settings, as well as in community rehabilitation and detoxification centres.
A highlight of Dush’s Fellowship was his visit to the medically supervised injection site ‘Insite’. Since opening in 2003, the centre has been used by over 10,000 injecting drug users (up to 700 per day) who may otherwise have injected unsafely in a public setting, and potentially been at risk of contracting HIV and other BBVs through shared needles and utensils. Despite repeated legal attempts to close the unit, it remains open, and is an example of how controversial government-funded initiatives can gain gradual acceptance if they can demonstrate their usefulness to the surrounding community.
Dush also looked at initiatives for improving understanding of substance misuse among healthcare professionals. In his report, he argues for greater investment into training and education in Addiction Medicine sub-specialty within the specialty of psychiatry.
“In Vancouver, a city with double opiate use and overdose crises in its downtown areas, success in tackling substance misuse issues has been possible because of a multi-disciplinary approach which has been open to using novel interventions. The setting up of ‘Insite’, North America’s first ever medically supervised injecting site, is one inspirational example of this” -Dr Dush Mital
Now back in the UK, Dush will aim to disseminate his findings at a local, regional and national level in order to take forward his recommendations.
Read Dush’s report here
Notes to Editors
The Royal College of Physicians of Edinburgh
The Royal College of Physicians of Edinburgh aims to improve the quality of patient care. It represents over 12,000 Fellows and Members worldwide, setting standards and influencing health policy. The College helps physicians and related specialties pursue their careers through its world-renowned education and training programme, while maintaining the highest standards in training, assessment and continuing professional development.
The College is working with the WCMT to support one Fellowship for a doctor per year in the three-year Patient Care project, and will help disseminate the findings.