On June 1, 2022, BC Emergency Health Services (BCEHS) introduced the new Assess, See, Treat and Refer (ASTaR) Pathway to serve people who use drugs throughout the province. With consent, paramedics connect people who have experienced a drug poisoning event but do not wish to go to hospital with outreach services within their geographical region.
“These outreach services include but are not limited to treatment, safe supplies, housing, peer support, and more. This pathway is one of many strategies BCEHS is putting in place for paramedics to reduce harm in their communities,” says Jennifer Bolster, a paramedic practice leader for BCEHS.
Those who agree are contacted at a later date by mental health and substance use (MHSU) workers within their regional health authority, and offered appropriate services based on their personal situation and preferences.
“Paramedics are often faced with a dilemma when drug poisoning patients refuse to go to the hospital. With this new pathway, paramedics have another avenue available to them to provide further care for the patients they see,” says paramedic specialist Brian Twaites.
The initiative allows first responders to connect with mental health and substance use services, to help provide people at risk with the supports they need.
“Not everyone who experiences a drug poisoning event wants to or even needs to come to the hospital,” says Amanda Lavigne, an Interior Health clinical nurse specialist. “There are many reasons why someone may decline transport to hospital after an overdose – fear of someone they love finding out, the feeling of shame and being stigmatized in our health-care settings. But we then need to provide them with options for follow-up and care in their community.
“You don’t need to be a mental health and substance use client to accept support after toxic drug poisoning. It’s about offering people what they may need in their community after a traumatic event.”
The opportunity for people to be connected to supports through this new process can be life changing, says Rikki Barden, a social worker at Royal Inland Hospital.
“You’ve got someone coming from a non-judgmental place to offer support to folks who may have never been attached to services, who have never reached out, and who may be hiding their addiction. Unlike someone who comes into the emergency department and then just wants to get out as quickly as possible, we can contact them after the fact on their own terms, and many people are really thankful for the opportunity to tell their story and be offered support.”
There is an emphasis on protecting people’s privacy and being person-centred.
“It’s so important that people get an opportunity to get connected to services, especially in the midst of this terrible toxic drug crisis,” says Barden.