Heather’s research will investigate the relationship between stimulant use and treatment outcomes among patients receiving injectable medical-grade heroin and hydromorphone for the treatment of long-term opioid-dependence in Vancouver. Findings will inform the planning and provision of services as these treatments are scaled up in Vancouver and expanded across Canada.

Research Description

My research is focused on patients receiving diacetylmorphine (medical-grade heroin) and hydromorphone (a licensed opioid) for chronic opioid-dependence at Providence Health Care’s Crosstown Clinic in Vancouver, the only site in North America where this treatment is delivered. For people that have not been reached by available first line treatments, evidence suggests this treatment to be safe, effective, and cost-effective with high retention and reductions in illicit opioid use. Nevertheless, high rates of illicit stimulant use persist, often necessitating engagement in illicit activities, and interfering with Crosstown Clinic treatment outcomes. Given Crosstown patients visit the clinic daily, there is a tremendous opportunity for the integration of services to meet the needs of patients that use stimulants. My dissertation will explore the treatment experiences and outcomes of Crosstown patients that use stimulants. Evidence will inform the provision of services for stimulant users as treatment with medical-grade heroin and hydromorphone expand across Canada.

Heather Palis, 2017 Killam Doctoral Scholar

What does being a Public Scholar mean to you?

Scholars are defined as individuals that hold highly specialized knowledge on a particular topic. As a public scholar, I recognize that the knowledge I hold can only be meaningful when I engage with the public in the community where my scholarly work is situated. As a public scholar, it is my role to seek out and honour the profound knowledge existing among various existing stakeholders, including Crosstown Clinic patients and health care providers, local health care decision makers and advocacy groups. This means building relationships and collaborations, and engaging these groups throughout the research process to promote the relevance and significance of the research in practice.

In what ways do you think the PhD experience can be re-imagined with the Public Scholars Initiative?

The PSI offers PhD students a platform to reflect upon how their research is timely and important in practice, and to follow this with action to build connections between their academic work and the public. This can mean that rather than engaging with public audiences to disseminate findings when the dissertation is complete, students are encouraged to consider public engagement throughout their dissertation work. This is productive for the student in considering the development of skills and abilities surrounding communicating with publics that may otherwise be lacking from doctoral studies, but also provides a public benefit in increasing the potential impact of the dissertation work in the communities where the dissertation work is located.

How do you envision connecting your PhD work with broader career possibilities?

Given my PhD work is focused on a group of patients receiving treatment in Vancouver, I have an opportunity to engage face to face with study participants, with health care providers delivering this treatment and with other stakeholders such as community organizations and health care decision makers. This has given me a level of comfort and confidence in working in a collaborative and multi-disciplinary environment, which I will carry with me in my future research and post-PhD career.

How does your research engage with the larger community and social partners?

My Doctoral Dissertation engages knowledge users including Crosstown Clinic health care providers and local health care decision makers. These stakeholders will be involved in the stages of developing research questions, analysis, and interpretation. Engagement of these knowledge users is particularly appropriate for my proposed research given addiction is multidisciplinary in nature, and necessitates attention not just to a patient’s medical condition, but to histories of trauma, current social relationships and housing conditions, psychological health, criminal justice system involvement, etc. As such, collaboration with non- academic partners is extremely important, to ensure perspectives from various disciplines that have a role in treating patients (e.g. nursing, social work, policy) have been accounted for.

How do you hope your work can make a contribution to the “public good”?

My research will bring together the perspectives of various stakeholders. As part of my dissertation work, these perspectives will be synthesized into a policy brief. The policy brief provides a platform for a contribution to public good, with recommendations for approaches to integrating services for Crosstown Clinic patients that use stimulants. The synthesis of these findings into a policy brief will make findings accessible to key decision makers and will enhance the potential for this research to contribute to meaningful change in practice, in settings across British Columbia and Canada as access to injectable opioid assisted treatment (i.e. diacetylmorphine and hydromorphone) (iOAT) is scaled up. Fidnings will improving the health and safety of iOAT patients that use stimulants and the communities where they live.

Why did you decide to pursue a graduate degree?

My pursuit of a graduate degree was largely motivated by the opportunity to study alternative opioid assisted treatments for people that do not respond well to available first line treatments. With alternative treatments comes an opportunity to attract and retain people into care that otherwise would be left outside of the health care and addiction treatment systems.

Why did you choose to come to British Columbia and study at UBC?

I was drawn to UBC by the opportunity to work with a multidisciplinary, collaborative team led by my supervisor, Dr. Eugenia Oviedo-Joekes at the School of Population and Public Health. My studies have provided me with the opportunity to collaborate with a range of researchers, health care providers, policymakers and people with lived experience that are working on improving addiction treatment and services in Vancouver.

What is it specifically, that your program offers, that attracted you?

The School of Population and Public Health offers rigorous training in both quantitative and qualitative methods. This exposure to a broad range of training was important to me and has helped to prepare me to carry out a mixed methods dissertation.

What aspect of your graduate program do you enjoy the most or are looking forward to with the greatest curiosity?

While I appreciate all that I have learned from the components of my program thus far, I am now looking forward to beginning data collection. This will include one on one interviews with patients receiving supervised injectable opioid-assisted treatment at Providence Health Care's Crosstown Clinic in Vancouver.

Do you have any tips for students from your home country coming to Canada / to UBC Grad School?

As a graduate student, there will always be work to do. It is not a race. Take care of yourself first; your work will still be there tomorrow.