Background Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, Canada, clients were prohibited from injecting their peers; only recently has this practise been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injection provider and recipient; the role of pragmatism; trust and expertise; and gender relations. Methods In this qualitative study, participants (n = 16) were recruited to be interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Interview data were transcribed and thematically analyzed. Quantitative administrative data were used to provide context and to describe the study population, comprised of people in the PAIP (n = 248). Results PAIP clients made up 17.4% of all SCS clients. PAIP clients were more likely to be female and Indigenous. Injection providers expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors related to the injection provider-recipient relationship were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP which included adding more inhalation rooms so that if someone was unable to inject they could smoke in a safe place instead. Additionally, being required by law to divide drugs outside of the SCS, prior to preparing and using in the site, created unsafe conditions for clients. Conclusions Regular use of the SCS, and access to its resources, enabled participants to lower their risk through smoking and to practice lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

Background Peer assistance is an emerging area of study in intravenous drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In Alberta, a government-sanctioned SCS recently received federal exemption to allow peer-assisted injection in their facility, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection, while scant, addresses several topics: interpersonal relationships between the injector and recipient; the roles of ritual and pragmatism; and gender inequality. Methods In this qualitative, descriptive study, participants were interviewed about their experiences in a peer-assist program at an SCS regulated by Health Canada. Results Participants expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the peer-assist program. Conclusions These findings reveal the humanity within a cohort of at-risk individuals, often dehumanized at the societal level. Relational equity and mutuality were evident, in contrast to other studies. Regular use of the SCS, and access to its resources, enabled participants to make healthier choices and practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.

No abstract

UNSTRUCTURED Canada is a progressive nation which endeavours to provide comprehensive, universal, and portable healthcare to all its citizens. This is a challenge for a country which has a population of 38 million living within a land expanse of 10 million km2 and where 18% are living in rural or extremely remote locations. The combined population of Yukon, Northwest Territories and Nunavut is only 128,959 living within 3.92 million km2 and many of these citizens live in isolated communities with unique health needs and social issues. The current solutions to providing healthcare in the most remote locations have been to transport the patient to the healthcare provider or vice versa, which incurs considerable financial strain on our healthcare system and personal stress to the patient and provider. The recent deployment of Low Earth Orbit communication satellites (LEO-ComSats) globally will change the practice and availability of virtual medicine everywhere in the world, especially northern Canada. The deployment of LEO-ComSats could result in disruptive but positive changes in medical care for underserved communities in remote geographic locations across Canada. LEO-ComSats can be used to demonstrate the utility of virtual medical encounters between a patient and a doctor in Canada separated by thousands of kilometers. Most certainly the academic medical centers in lower Canada could perform virtual tele-mentored medical care to our northern communities in a manner similar to the virtual care provided to many Canadians during the COVID-19 pandemic.

Background: Peer assistance is an emerging area of study in injection drug use. When Canada’s first supervised consumption site (SCS) opened in 2003 in Vancouver, BC, clients were prohibited from injecting their peers; only recently has this practice been introduced as a harm reduction measure at these sites. In 2018, Health Canada granted federal exemption to allow peer-assisted injection at certain SCS sites, under the Controlled Drugs and Substances Act. Literature pertaining to peer-assisted injection addresses several topics: interpersonal relationships between the injection provider and recipient; the role of pragmatism; trust and expertise; and gender relations. Methods: In this qualitative study, participants (n=16) were recruited to be interviewed about their experiences in a peer-assisted injection program (PAIP) at one SCS regulated by Health Canada. Interview data were transcribed and thematically analyzed. Quantitative administrative data was used to provide context and to describe the study population, comprised of people in the PAIP (n=248) Results: PAIP clients made up 17.4% of all SCS clients. PAIP clients were more likely to be female and Indigenous. Injection providers expressed being moved by compassion to help others inject. While their desire to assist was pragmatic, they felt a significant burden of responsibility for the outcomes. Other prominent factors related to the injection provider-recipient relationship were social connection, trust, safety, social capital, and reciprocity. Participants also made suggestions for improving the PAIP which included adding more inhalation rooms so that if someone was unable to inject they could smoke in a safe place instead. Additionally, being required by law to divide drugs outside of the SCS, prior to preparing and using in the site, created unsafe conditions for clients. Conclusions: Regular use of the SCS, and access to its resources, enabled participants to lower their risk through smoking and to practise lower-risk injections. At the federal level, there is considerable room to advocate for allowing clients to divide drugs safely within the SCS, and to increase capacity for safer alternatives such as inhalation.