Dr. Kora DeBeck is a Research Scientist with the BC Centre on Substance Use and Distinguished Professor in the School of Public Policy at Simon Fraser University. She holds a CIHR Applied Public Health Chair and is a Dorothy Killam Fellow. She has also recently been invited to the Royal Society of Canada College of New Scholars, Artists, and Scientists.

Her research aims to drive reforms in substance use policy and health services through exploring the individual, social, and structural factors that influence the health and well-being of people who use drugs.

We asked Dr. DeBeck about her recent awards and acknowledgements as well as her ongoing research.

Q: Congratulations on the Dorothy Killam fellowship, the CIHR Applied Public Health Chair and being invited to the Royal Society of Canada College of New Scholars, Artists, and Scientists! What do these awards and this recognition mean to you?

Receiving these awards and this acknowledgement feels like an important recognition of the urgency of the toxic drug crisis. They validate and recognize the need for transformative evidence-based change. Receiving this support and funding in such a deeply politicized area emphasizes the importance of including people with lived and living expertise, focusing on equity-oriented work, and using evidence to inform public policy.

 I think the most exciting part is having these established credible bodies recognize and invest in research for evidence-based drug policy. The CIHR Applied Public Health Chair also provides a mechanism to connect with people in community and government, to ensure that we're creating data-driven, actionable evidence that is grounded in the priorities of community. I’m optimistic that these awards will help elevate our research and position us to make an impact on substance use policy and practice. I look forward to leveraging the opportunities and platforms they provide to help drive much needed transformation in drug policy and practice.

Q: Tell me about ARYS cohort study and some of your key findings.

The At-Risk Youth Study (ARYS) is a multi-year cohort study of street-involved youth aiming to explore the individual, social, and structural factors that influence health and well-being. I think ARYS is uniquely positioned to offer compelling evidence, not just for government decision makers, but also for the public – improving understandings of harms of drug criminalization, and highlighting the need for transformative evidence-based change that allows for a comprehensive approach to the complexities of substance use.

Over the course of almost 20 years, one of the key emerging themes from ARYS data is the importance of early social determinants of substance use: drawing narratives away from the idea that substance use is an individual moral failing. Early childhood trauma and its prevalence has been linked with high-risk of substance use later on. Substance use is situated within the context of very complex lived realities of people that are often marked by early childhood trauma and other structural factors, like poverty and discrimination, that have impacted their lives.

Another reoccurring finding has been that people who use drugs and their surrounding communities are not being served by drug criminalization. Drug law enforcement is ineffective and carries serious negative harms for structurally vulnerable populations and the public at large. One of the things that I am concerned about from a policy perspective is a seeming refusal to acknowledge the central failure of drug criminalization and what I call ‘magical thinking’ about the potential role that addiction treatment can play in addressing the toxic drug crisis. While addiction treatment is worthwhile and incredibly important, we know from years of study and experience that it is limited in reach and scope. To meaningfully reduce toxic drug poisonings, we are going to need to address the supply of drugs. Exploring how we can give people at risk of drug related harms access to a regulated supply of drugs of known purity and context while preventing unintended consequences in other areas is a key priority for our research team and one that the ARYS cohort is well positioned to contribute to.

Q: Who do you collaborate with in your research and who would you like to work with more?

I think for this work to be successful, one of the key aspects is having trusting relationships with different parties. This means working with community and people who use drugs, and also with government. We need to understand the constraints and the opportunities relating to substance use and younger people. To help us with this, our research is shaped by ARYS Community Research Associates, an Indigenous Collaborators Circle and government partners. These relationships help guide our research activities and validate data that we're getting from the research with people in the community. We want to ensure that we can match community priorities and needs with the kind of research evidence that is practical for government.

I think that it's also really important that we're not just grounding our research within community, and government, but also making sure that we bridge that understanding with the public. Currently there are many narratives about substance use and drug policy in the media and public that are not supported by research evidence and data. Helping to correct these narratives is something we aim to do. When government implements progressing drug policy approaches, the public should understand why government is making the kinds of decisions that it's making it. This will hopefully support more progressive, transformative drug policy and prevent unnecessary drug related harms including toxic poisonings.