Five Years of Overdose Prevention and Education Network

Written by: Prairie Chiu, Project Manager – Overdose Prevention and Education Network (OPEN)

OPEN’s grantees have not only been measured by the success of its strategies or projects, but by the growth of its community leaders, the increased capacity of the organizations or peer groups involved, and the strength of the relationships grantees have built with community partners […] But perhaps a more profound achievement of the network is that its members have not wavered in their commitment to community-driven overdose response, despite an unending, unrelenting overdose public health emergency.

April 2021 marks the fifth anniversary of the overdose public health emergency declaration in British Columbia. As we share our grantees’ events and coordinate social media posts to mark the occasion, Project Manager Prairie Chiu reflects on five full years of the Overdose Prevention and Education Network Project at CAI.

OPEN Knowledge Exchange event participant reflections

The initiation of OPEN

In 2016, faced with the first public health emergency ever declared in BC, CAI’s leadership sought government approval to utilize some of its existing public funds to support community overdose response. Historically, granting calls at CAI provided a small number of community-based organizations with multi-year programmatic funds, with each cycle of grants focused on a specific funding gap identified by CAI’s Leadership Council. What was needed now was a strategic granting call that both flowed funds to a greater number of grantees and facilitated the kind of coordinated community response that complex problems such as illicit drug overdose need—something individual organizations could not do alone. With the hiring of a coordinator with lived/living experience of substance use and professional experience of drug user advocacy, the first such at CAI, the OPEN Project was established. The first round of OPEN grants, Convening Grants, were given out to lead agencies responsible for convening community stakeholders to build relationships and co-create a local action plan. The grants funded many large community events and meetings.

OPEN’s coordinator infused OPEN with many of its core principles. As a person with lived/living experience, he established the Nothing About Us Without Us principle as the primary guiding principle of OPEN. He amassed many peer engagement and advocacy resources, connected CAI with grassroots groups, and planned concrete supports for grantees, such as Naloxone kits and Motivational Interviewing training, that were responsive to their needs. When he left CAI, the principles of OPEN were already set—community-centered, meaningful peer engagement, and responsive to community-identified needs.

The OPEN model

As OPEN’s new coordinator, I didn’t have the lived experience of its co-initiator. But my social work values and direct service experience aligned easily with OPEN’s principles. Together with a new CAI Director, we broadened OPEN, envisioning it as a multi-phase project with a network model that had the potential of disrupting traditional funding practices and impacting the mental health and substance use sector in a collective way while remaining nimble in an evolving crisis. We shifted OPEN to fund coalitions instead of organizations. We decoupled grant payments from project deliverables. We took an active role in gathering project information—doing site visits, documenting, and establishing processes and relationships with grantees that took into account the power dynamic between a funder and a grantee. Most importantly, through training and knowledge exchange opportunities, we continued to build the capacity of grantees to do meaningful peer engagement, which we saw as the key to a sustained systems level change.

What emerged from OPEN

Discussion at Groundswell 2018

Although the core components of each phase remained the same: review and renewal of grants for grantees, low barrier and flexible grant management, at least one knowledge exchange opportunity, and additional training or capacity building opportunities in areas they identified or requested, each of OPEN’s four phases were distinct.

Looking back, training and capacity building opportunities in each phase mirrored the development of the OPEN coalitions, and the development of the community overdose response itself. Some of the OPEN grantees came into the network as pre-existing community coalitions, and at least a few of OPEN’s coalitions have become Community Action Teams, funded by the Overdose Emergency Response Centre. But for the rest, the four phases of OPEN have largely unfolded as: convening community partners to create a local action plan; implementing that plan, which includes engaging peers; strengthening peer engagement and making inroads with community stakeholders, and finally, doing advocacy and supporting peer self-determination.

In a parallel process with OPEN’s grantees, CAI was also building its capacity as a funder. OPEN’s principles of community-centered, meaningful peer engagement, and responsiveness to community-identified needs became CAI principles. The OPEN Project was the first project at CAI to have a community-based advisory committee that adjudicated grants, to pay an honorarium to peers, to host a provincial event with harm reduction supports, to fund peer-based groups, to do telephone check-ins in lieu of written reports for grant management, and to partner with provincial drug user groups. OPEN is also the first grant at CAI to allow funds to be allocated to peer coordinator roles, peer honoraria, and cultural supplies such as Indigenous medicines. OPEN is a project with many firsts for CAI, and it remains one of the only current projects at CAI that is 100% initiated and led by us.

OPEN’s successes and impact

SUSTAIN (Substance Users Society Teaching Advocacy Instead of Neglect) is a harm reduction peer-led project.

Over the span of nearly five years, the remarkable accomplishments of OPEN’s grantees have not only been measured by the success of its strategies or projects, but by the growth of its community leaders, the increased capacity of the organizations or peer groups involved, and the strength of the relationships grantees have built with community partners.

The Vancouver Aboriginal Community Policing Centre, which had operated Indigenous outreach patrols in the DTES, recently established the Smoke Signals Outreach Hub, a rapidly growing space led by peer leader Chris Livingstone. The SUSTAIN (Substance Users Society Teaching Advocacy Instead of Neglect) peer-led network of people who use drugs has emerged to become a strong voice of advocacy in Powell River, sitting at regional decision-making tables and staffing its Overdose Prevention Site. Regional Community Action Team Coordinator and Registered Clinical Counsellor Amanda Erickson began working with the Nelson Fentanyl Task Force, and now coordinates the two other regional Community Action Teams—the Castlegar Fentanyl Opioid Working Group and the Grand Fork Community Action Team. Pathways Addictions Resources Centre in Penticton has piloted the Intensive Coordinated-Care Opioid Navigator (ICCON) program, which has served over 120 clients since 2018, each year expanding to include more supports for clients and their families. Quesnel Shelter and Support Society, with its partners, has provided funds, support and capacity building to two local peer groups, the Clean Team and Coalition of Substance Users of the North (CSUN). CSUN became the first drug user organization in the northern region and successfully set up its own physical space. The Port Alberni Harm Reduction Roundtable for Youth Services built a relationship with School District 70 that allowed them to go into schools and provide Overdose Alertness training to youth, when previously they were unable to do so. And after operating without funding since its inception in 2009, BC/Yukon Association of Drug War Survivors, a group of drug user groups, finally secured funding to support a provincial peer network. These are but a sample of the myriad accomplishments that CAI is aware of, and they are by no means inclusive of all of OPEN’s grantees’ accomplishments!

But perhaps a more profound achievement of the network is that its members have not wavered in their commitment to community-driven overdose response, despite an unending, unrelenting overdose public health emergency. I cannot count the number of times a grantee has come on to a meeting call with me and reported that they had just come from supporting staff or peers through an overdose, or the number of times a peer has mentioned that they lost a close friend or community member to overdose that week. It has often felt irreverent or offensive to discuss something as practical as budgets when grantees are essentially soldiers on a battlefield, facing the same traumatic loss and grief as any enlist of the military. Yet our grantees persist, drawing on deep reserves of compassion, servitude, reliability, and dedication. In the initial weeks of the COVID-19 pandemic response, peer leaders and peer groups in multiple communities stepped up to support people who use drugs in the vacuum left by retreating social services. They provided meals from parking lots as hot meal services shrank to once a day or less, organized clothing drives as folks lost access to shelters, offering their personal vehicles or other sites for warmth, provided harm reduction supplies as Overdose Prevention Sites reduced their capacity, and advocated for individuals to access medical safe supply. As overdose fatalities spiked, we know that peers and their allies worked around the clock, initially without any or adequate PPE, and then without reprieve for illness, grief/loss, or plain exhaustion. A year into the pandemic, with overdose fatalities at an all-time high in the province, they have not relented.

What I learned and will take away with me

Chris Livingstone & Prairie Chiu at the OPEN Knowledge Exchange Event 2019

OPEN has been the crowning experience of my working life. Every day that I work for CAI, I am intensely aware that it is an honour to work alongside alongside a provincial network of people who are each doing all that is humanly possible to save their friends, to save their fellow community members. Through each phase of OPEN, CAI also empowered me to build capacity building components that could support OPEN. For that, I am extremely grateful. I have learned so much through my role managing the OPEN Project. I learned how much work it is to put on a provincial conference, yikes! I learned that a little bit of money goes a long way—the grants don’t have to be large—and those who stretch the money furthest are often the most without. I learned that there are allies who are willing to lend their support, to give training, consultation, expertise, without expecting anything in return. I learned that often, one or two individuals can make a huge difference in a community. I learned that the work is predicated upon relationships: I am honoured to be trusted with traumatic stories, difficult dilemmas, and interpersonal conflicts. I learned that with the greatest adversity often comes the greatest strength. Most importantly, I learned to follow. In the Local Action phase, the Peer Mentorship Bursary was initiated and developed collaboratively with three established drug user groups after they shot down CAI’s idea of a video series. The one-year program supported 17 peers to spend one week at a mentorship site of their choice, and it had positive impacts on the subsequent development of OPEN’s peer groups.

As OPEN comes to a close, I regret that I won’t be able to complete site visits of all the grantees—I have been a guest at conferences and events, and the value of meeting people and witnessing the work first-hand is unmeasurable. I also regret that CAI is unable to offer grants to all groups that need them. I will miss being able to support grantees in small ways—for example, offering flexibility in a budget. I am humbled by the remarkable people I have met through the OPEN Project, and I will miss my work with them.

How we will stay connected and honour the relationships

As we mark the five-year anniversary of the overdose public health emergency, CAI continues to support community and partner with the Overdose Emergency Response Centre. Through OPEN, CAI has invested in the actors of the provincial overdose response, its peer leaders and allies, and we will persevere to trust that the projects that arise from their work are what community needs, and hence what CAI should be funding.

Finally, I am inviting you to attend “Five Years of Crisis | Five Years of Community Response,” the final time that OPEN grantees will come together to present and acknowledge the cumulative impact of five years of community overdose prevention, education and response. Over this 3-hour online event, grantees will present knowledge products that they have created to summarize or support their work. Attendees will also have a chance to contribute to provincial calls-to-action.

I hope that you will join me in honouring the work of OPEN, and acknowledging all those who have changed their communities, changed CAI, and changed me forever.

Opening the OPEN Knowledge Exchange Conference 2019