Abstract
BackgroundThis article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada’s first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP’s members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver. This article highlights SNAP members’ experiences as research subjects in Canada’s second clinical trial conducted in Vancouver, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), that began recruitment of research participants in 2011.MethodsThis paper draws on one brainstorming session, three focus groups, and field notes, with the SALOME/NAOMI Association of Patients (SNAP) in late 2013 about their experiences as research subjects in Canada’s second clinical trial, SALOME in the DTES of Vancouver, and fieldwork from a 6-year period (March 2011 to February 2017) with SNAP members. SNAP’s research draws on research principles developed by drug user groups and critical methodological frameworks on community-based research for social justice.ResultsThe results illuminate how participating in the SALOME clinical trial impacted the lives of SNAP members. In addition, the findings reveal how SNAP member’s advocacy for HAT impacts the group in positive ways. Seven major themes emerged from the analysis of the brainstorming and focus groups: life prior to SALOME, the clinic setting and routine, stability, 6-month transition, support, exiting the trial and ethics, and collective action, including their participation in a constitutional challenge in the Supreme Court of BC to continue receiving HAT once the SALOME trial ended.ConclusionsHAT benefits SNAP members. They argue that permanent HAT programs should be established in Canada because they are an effective harm reduction initiative, one that also reduces opioid overdose deaths.
Highlights
This article highlights the experiences of a peer-run group, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME)/North America Opiate Medication Initiative (NAOMI) Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada
As we complete this paper in April 2017, the Downtown Eastside (DTES) of Vancouver, in the province of British Columbia (BC), Canada, is experiencing the worst opioid overdose crisis in its history
Due to the unprecedented number of overdose deaths in the province, in April 2016, a public health emergency was announced by Dr Perry Kendall, the BC Provincial Health Officer [1, 2]
Summary
This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. In order to contextualize the experiences of SNAP members, we provide a brief history of publicly funded drug treatment and two clinical trials in Canada. It may surprise readers to learn that Canada did not set up publicly funded drug treatment programs after heroin and other drugs were criminalized in the early 1900s. It was not until the late 1950s and 1960s that the first publicly funded drug treatment programs were set up in secure units in prisons, rather than in the community. The Commission recommended that prison time for possession of criminalized drugs such as heroin should end [6]
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