Organizers of a pop-up overdose-prevention site close to Nanaimo Regional General Hospital are calling on Island Health to do more following a report of an overdose death in a hospital washroom this week.
Dr. Jessica Wilder, who works in family and addictions medicine and is an organizer of the pop-up overdose-prevention site across the road from the hospital, said the incident occurred overnight Tuesday, Nov. 19.
"I have provided care for this patient for years and some of our nurses have known this patient for over 15 years," Wilder told the News Bulletin. "He had recently become housed and we hadn't really seen him pop up in the hospital much lately, but he had presented to the emergency department Monday and he was quite sick."
According to Wilder, while the individual was awaiting further medical care, nurses supported him in visiting the unsanctioned pop-up overdose prevention site. He used an illicit substance on site and left without issue.
Overdose-prevention sites are monitored locations where individuals are permitted to use their own illicit drugs, with fully equipped medical staff on standby to administer first aid if required.
The next morning at approximately 4 a.m. when the site was closed, he went into an emergency department washroom, used drugs alone, and fatally overdosed. By the time staff found him, Wilder said it was too late. Narcan was used and emergency staff provided CPR, but the patient died. Wilder said in a permanent overdose-prevention site, this wouldn't have happened.
"This is exactly an example of why we need a service like an overdose-prevention site at the hospital," she said, "because this patient showed he wanted support to stay well so that he could be in the hospital and receive care. He showed that when given a safe space he would use it and when that safe space was not available to him, he used in an unsafe way."
She called the addition of an overdose-prevention site at the hospital a simple intervention.
"We are eight years into this crisis and we have a health authority that we rely on to keep us safe and to keep us healthy and to develop health-care policies to keep us alive. In eight years, that's enough time to have established every evidence-based intervention to reduce harms and save lives and we should have every single one accessible and available to everybody and meanwhile we're still fighting for some of the simplest and most basic interventions like an overdose- prevention site."
The unsanctioned pop-up site, which opened on Monday, Nov. 18, is planned to run until Friday, Nov. 22, operating between 10 a.m. and 6 p.m. During its first three days, Wilder said there have been 15 instances of supervised drug use at the site, no overdoses and multiple connections to community supports including treatment and housing.
"We all gathered yesterday morning when we learned of this news and we took a moment to honour this patient and share stories about him. We cried and we hugged and we took care of one another and then collectively decided how best to find some small glimmer of goodness in this," the doctor said. "This is a devastating and unnecessary death and we all agreed this patient would want us to share this story so other people could better understand why we are here doing the work that we are doing."
In a statement, Island Health said they extend their deepest condolences to the family and friends of the victim, but can't speak to the specific details due to privacy.
"Any time there is an unexpected death, there is a well-established process in place through the patient safety learning system to ensure all factors are reviewed and understood, and any potential system, process, or practice improvements are identified and implemented," Island Health commented.
In a previous statement on the opening of the unsanctioned site, Dr. R茅ka Gustafson, Island Health's chief medical health officer told the News Bulletin that Island Health "is committed to ensuring all people are treated with respect and dignity, and patients who use substances receive equitable and accessible care that is free from stigma and judgment."
She noted that major hospitals including NRGH have addictions medicine consult service teams embedded, with clinicians focused on care that manages patients' withdrawal symptoms related to substance use and reduces the need for substance use while admitted to hospital.
"These expert teams, including specialized physicians, work closely with patients who use substances to develop unique and tailored care plans that meet the needs of patients, protect the safety of staff and other patients, and align with provincial policies and regulations," Gustafson said.
