BC Centre on Substance Use Strategic Plan
Our plan to improve lives by transforming substance use policy and practice
An estimated one in every five Canadians will be impacted by substance use and related harms in their lifetime. That's more than six million people. For the majority of them, the health system will fail to meet their needs. For those without an addiction who use substances, especially unregulated substances, policies put them in harm’s way every day. Collectively we can — and must — do better.
The BC Centre on Substance Use was established in 2017 to provide a centre of expertise to help meet those needs. We aim to be highly collaborative and coordinated in our approach. We place emphasis on research to generate evidence-informed strategies, while harnessing clinical guidance and training to ensure that evidence is implemented into clinical practice in every part of the province. A great deal of work remains to be done. This plan outlines the next steps to make this a reality.
The BCCSU emerged from years of provincial planning focused on the need for a centre focused on substance use and addiction.
The Urban Health Research Initiative (UHRI), a former program within the BC Centre for Excellence in HIV/AIDS, would serve as the launching pad for the creation of the BCCSU. First established in 2006, UHRI quickly became an internationally recognized leader in substance use research. Evidence from research scientists at UHRI would help transform BC and Canada's approach to drug policy, creating the science to support approaches that were controversial at the time but are now widely accepted — from supervised consumption sites to needle distribution programs.
From this foundation, the BCCSU was established in April 2017. Building on the core pillar of research expertise from UHRI, the BCCSU incorporated clinical care guidance and health professional education and training in order to advance our knowledge of the spectrum of both harms and benefits of substance use and substance use disorders including alcohol, opioids, cannabis and stimulants. In a very short time the BCCSU was able to expand to include multidisciplinary team of exceptionally talented and committed staff with collaborative partnerships with stakeholders, including a strong connection to the community of people with lived and living experience with substance use.
The provincial overdose public health emergency, declared in 2016, would — and continues to — be a priority for the BCCSU. The BCCSU immediately led the development of the first-ever provincial clinical care guidance for opioid use disorder and assumed responsibility and expanded training of health care professionals to improve the delivery of evidence-informed addiction treatment and care. In 2017, just over 700 trained prescribers of opioid agonist treatments were practicing. Over the first four years of the BCCSU’s operations, that number would increase by nearly 150%. The BCCSU would also help train thousands of clinicians, through online learning, outreach seminars, and preceptorships, and by hosting the largest addiction medicine training program in North America. Dozens of provincial and national treatment guidelines have been published, helping to close the evidence-to-practice gaps that are prevalent in health care. Numerous studies generated through the BCCSU, ranging from program evaluation to clinical research, have led to hundreds of published peer-reviewed articles each year, research awards, conference presentations, other knowledge products and engagement activities that have helped to inform the response to ongoing toxic drug deaths.
The dual public health emergencies of COVID-19 and overdoses have made very clear the need for policy changes alongside improvements across the full range of substance use services. The pandemic has amplified the many challenges people who use substances face in accessing care and social supports and, as a result, people are dying of toxic drug poisonings at unprecedented rates while substance use — from regulated substances like alcohol to unregulated substances like illicit opioids — rises. Harms resulting from certain substance use are driven largely by stigma and a long history of criminalization, preventing the necessary resources and cross-sectoral responses needed to end toxic drug deaths, connect people to treatment, and prevent substance use. It does not have to be this way.
Policies and programs can promote equity and well-being if they are grounded in evidence and lived experience. But this requires change.
Collectively, we must:
- End stigma and discrimination towards people who use substances, those in recovery from addiction, and their families and communities who love and care for them. This includes ending the criminalization of substance use and providing education and health promotion strategies to the community that target the root causes of substance use harms.
- Address the harms perpetuated by ongoing racist and colonial policies and systems, which are inextricably linked to the disproportionate impact of substance use on Indigenous peoples.
- Work must continue to act on the recommendations from the 2020 In Plain Sight Report and the 2015 Truth and Reconciliation Calls to Action and incorporating principles of anti-oppression, anti-Indigenous racism, and Indigenous reconciliation in research, clinical guidance, and education is paramount.
- Enhance substance use research, addiction clinical care guidance, and health care professional education to support the development of a full substance use system of care that moves beyond the “problematic” framework towards a spectrum that includes not only people with a substance use disorder, but also the many others who use substances for a variety of reasons — socially, medicinally — but may never experience harms from their substance use.
- Implement policies that minimize the harms and promote health and equity to provide people with the necessary supports — from housing to income — in order to support their wellness. This includes providing immediate, accessible, and effective health care for people who use substances — regardless of who they are or where they live — that is free of stigma and promotes health and well-being.
This change is possible. A better future for people who use substances is possible and, driven by research and evidence from lived experience, is within our grasp.
Ending substance use harms
We envision a future where the well-being of people who use substances is enabled through evidence-informed policies and practice that promote equity and are free of stigma and other forms of discrimination.
Networking researchers, educators, and care providers
We build networks of expertise with the shared goal of improving substance use policy and practice by conducting and mobilizing research, developing and supporting implementation of clinical care guidance, and training health care professionals.
Conducting and using the highest quality science to advance evidence-informed policies and practices.
Mobilizing evidence in all its forms to advance social justice and inform policy and practice.
Collaborating with people with a range of expertise and experiences because substance use is complex and responses require cooperation.
Addressing stigma and discrimination to promote fairness, justice, and well-being.
Progressing substance use policy, programming, and practice through curiosity, boldness, and creativity.
The BCCSU is dedicated to taking action around a set of strategic areas of focus over the next three years. Centred around our core functions of research, clinical care guidance, and health care professional education, these areas of focus will help transform approaches to substance use. We’ve also identified objectives that will strengthen our organization and build our relationships with partners so that together we can address the inequity many people who use substances experience.Strategic Areas of Focus
- Pursuing Research Excellence
- Delivering Innovative Education & Training
- Developing Transformative Clinical Guidance
- Advancing Equity, Diversity & Inclusion
- Fostering Partnerships
- Growing our Organizational Culture & Sustainability
This strategic plan is only the beginning. It provides the framework that sets our priorities to continue to push the organization into its next phase. While not explicit, the ongoing work of the organization will still persist, individual research programs of investigators, partnerships with the First Nations Health Authority and our shared work plan with government, among other key activities. While circumstances may change over the next three years and require us to revisit these priorities, how we make those decisions will be guided by this strategic plan, by the values we share, and by our vision for a better future.
Alongside our strategic plan is an implementation plan that will ensure accountability and transparency by tracking progress over the next three years. We will set objectives, measure key results, and report back to our network of partners.
We are grateful for the time and input of all who contributed and gave feedback to this process. Our commitment is to put this strategy into action. We commit to living the values described here. And we commit to demonstrating this through regular reporting on its progress, accountability and transparency.