As homeless people were moved out of Oppenheimer Park, many were prescribed a safe supply of drugs

For Happy Kreter, doing outreach in Vancouver's Oppenheimer Park was an all-consuming activity going back as far as January.

Kreter, who works for the Portland Hotel Society (PHS), was at the park in the Downtown Eastside for the massive effort to meet a deadline earlier this month to clear the park and move the approximately 300 residents into housing.

He was also at the centre of a parallel effort to get drug users off the unpredictable, toxic supply of street drugs, and onto doctor-prescribed medications.

That push got some help from new pandemic prescribing guidelines issued by the provincial government in late March, as the COVID-19 situation in B.C. was beginning to look extremely worrying.

As a result, about one in 10 people living in Oppenheimer Park who moved out of a tent and into housing, also moved onto a prescription to replace their illicit drug use, at a time when the illicit supply was more contaminated than ever.

"The emergency orders seemed to free doctors up to prescribe how they saw fit for patients with substance use disorders," said Kreter. "So away we went."

Video meetings with doctors

As a first step, Kreter and other PHS staff spoke to people in the park who were using drugs. They invited them to a vacant office nearby, where a computer was set up for video meetings with doctors.

Kreter stood by as the PHS doctors assessed the patients, listened to how they were using drugs, discussed options, and in many cases, sent a prescription straight to a local pharmacy.

"Some people finished those conversations in tears," he said, adding that the patients described the experience as more patient-centred than previous interactions with doctors.

Kreter helped with paperwork — the medications are covered under B.C.'s Plan G, which applies to psychiatric drugs — helped with a urine sample if required, and even walked over to the pharmacy with the patient, if the assistance was welcomed.

214 people on safe supply prescriptions

According to PHS medical director Dr. Christy Sutherland, at least 214 people have been started on safe supply prescriptions in the Downtown Eastside since the new guidelines were announced.

Twenty-nine of those people were among the approximately 300 living at Oppenheimer Park, she said.

"Especially now, with a further interruption of the drug supply chain, further contamination of the illicit drug market — where drugs are more expensive and more contaminated than ever — we were so worried about that population as they moved into the various hotels around Vancouver," said Sutherland.

The BC Coroners Service said in March, more people were killed by overdoses than in any single month in a year. There were more overdose deaths than COVID-19 deaths.

New guidelines increased options

According to Sutherland, the new emergency guidelines made it easier to make more options available for patients.

For opioid users, prescriptions include suboxone, methadone and kadian — all available beforehand — but also hydromorphone, which is a short-acting pain medication previously only available as part of limited programs.

For stimulant users — people who use cocaine and methamphetamine — Sutherland can now prescribe Ritalin. There are also options for benzodiazepine users, though Sutherland says that's more complicated, given the unpredictability of the street supply.

She said one of the biggest improvements with the new guidelines, is that doctors can prescribe a dose that's more likely to ease the withdrawal symptoms from the start — previously, new patients would have to slowly increase their dose, meaning they were likely forced to stick with street drugs through the process.

Kreter said many of the Oppenheimer Park residents may have found their way to prescribed, safe drug supplies through their doctors, rather than the PHS effort. But he said there are still lots of people from the camp who could still benefit from the emergency prescribing guidelines.

"I would say there's still, from the park alone, there's over a hundred people who could still use a safe supply prescription," he said, adding that the work he and and his fellow outreach workers started at Oppenheimer continues, even though the main housing effort is behind them.

Do you have more to add to this story? Email rafferty.baker@cbc.ca

Follow Rafferty Baker on Twitter: @raffertybaker