Co-creating Health System Innovation with People Who Use Drugs in Central Edmonton

Study Lead: Ginetta Salvalaggio (Principal Investigator) & Renee McBeth (Co-Principal Investigator)

Funding Support: Canadian Institutes of Health Research  (CIHR)

Status: Completed

People who use drugs (PWUD) are facing a polycrisis of intersecting health threats including the toxic drug crisis, health disparities, coloniality, climate emergencies, income inequality, and unsheltered homelessness. This study responds to a need for collaborative research that centers PWUD in developing responses to the ongoing polycrisis. In partnership with Boyle Street Community Services (BSCS) we conducted narrative and arts-based research with PWUD who access inner city services in Edmonton, Alberta. Over a five-month period, researchers with combined academic, clinical, community, and lived experience engaged with 215 people and identified four key findings:

  • Care for Each Other

  • Professional Supports

  • Criminalization and Social Controls

  • Space to Be

To learn more about the findings, background, study design, and so much more check out our Final Report.

Recommendations for service organizations:

1. Support natural helpers in the community. This could include recognition or formal positions that amplify the role and value of natural helpers and/or supports for the helper’s own well-being.

2. Create opportunities for PWUD community members to gain skills through education and knowledge sharing that supports caring for one another. Redefine education so that it includes sharing knowledge from the street and for the street across generations.

3. Tailor supports to intersectional needs including mental health supports.

4. Ensure that support workers are respectful, compassionate, creative, ethical, and relationship-oriented to enable them to build and maintain trust with community members.

5. Identify opportunities to rapidly engage during key transitions. Supports are needed to get past initial hurdles involved with transition, including connecting PWUD with housing workers and healthcare providers. In particular:

  • Wildfire displacement

  • Youth aging out of care

  • Unhoused to housed

6. Provide space for community members to store their belongings safely during the day.

7. Seek lawyers in residence to help with legal issues.

8. Foster community care, connection and visiting in an Indigenous cultural context, recognizing the significance of kîhokêwin (visiting) “as a prairie Indigenous form of knowledge transfer.”

9. Build health-promoting programming that gives community members a place to be and supports a sense of purpose, belonging, and recreation, and income generation. Including:

  1. Quiet space to decompress.

  2. Community tech hub.

  3. Writing, music, time in nature or a community garden.

  4. Creating and selling artwork.

  5. Loss and grief support.

  6. Continue to provide the community with opportunities to share their stories.

  7. Celebrate how the community supports and cares for each other.

Recommendations for health care systems:

10. Build connections between health care systems, including emergency departments and primary care providers, with health-adjacent nonprofits. Work together to create safer systems of care, and bridge access to health care when clients need it.

Recommendations for municipal policymakers:

11. Support the right of PWUD and unhoused community members to spend time in public spaces without discrimination or punishments such as displacement, confiscation of personal items or fines.

12. Fund low-barrier drop-in spaces for PWUD community members where they can access care and build a sense of community and belonging.

Recommendations for provincial policy makers

13. Fund sufficient permanent supportive housing spaces for PWUD community members, using evidence-based approaches.

14. Support PWUD to stay housed by providing opportunities to reduce risk and to learn about tenant rights and responsibilities.

15. Ensure that all voluntary approaches to equip PWUD to heal and thrive are properly resourced, and all barriers removed, before contemplating more punitive models. This includes ready access to voluntary treatment, income support commensurate with provincial liveable income, and low-barrier healthcare access points such as supervised consumption services.

To read an article that describes our research process please click here

Follow the continued knowledge making and translation through this page.

Zine: Stories of the Street

One of the key arts-based knowledge mobilization is through the community developed Zine “Stores of the Street”, which includes community members personal stories, pictures of the collage making, and more. Special thanks to Veronica “Ronnie” Varewny for all their work on the Zine project.