Heather Palis

Research Topic

Daily treatment adherence and stimulant use among patients receiving supervised injectable opioid assisted treatment in Vancouver

Research Description

My research is focused on patients with severe opioid use disorder that have not been reached by available first line treatments and continue to inject illicit opioids. The continued injection of illicit opioids poses risk for a number of harms, including the spread of infectious disease, overdose, and overdose death. Evidence suggests that for this group, the provision of supervised injectable opioid-assisted treatment (siOAT) is a safe, effective, and cost-effective treatment. Providence Health Care’s Crosstown Clinic in Vancouver is the only clinic in North America where siOAT is offered. Patients visit the clinic up to three times daily to inject pharmaceutical grade opioids (i.e. medical heroin or hydromorphone) under the supervision of health care providers and are connected to ancillary services and supports. Outcomes include a significant reduction in street opioid use and high retention rates. Despite these positive outcomes, high rates of illicit stimulant use persist. This often necessitates involvement with illegal activities and interferes with daily treatment adherence, working in direct contrast to the primary aim of siOAT, namely keeping patients safe. Given patients visit the clinic daily, there is a tremendous opportunity for the integration of services to meet the health and treatment needs of siOAT patients that use stimulants in order to keep them engaged in this effective treatment daily. My dissertation will explore the treatment experiences and outcomes of siOAT patients that use stimulants. Evidence will inform the provision of services for stimulant users as this treatment expands to settings across Canada.

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.

Why did you decide to 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.


Why did you decide to pursue a graduate degree?

Through my undergraduate studies, I was briefly exposed to health research. The process of posing questions, eliciting hypotheses, investigating outcomes, and writing was exciting for me. I came to UBC as a Master of Science student with the intention of further exploring my enthusiasm for research. My time as a Master's student confirmed this interest, and shortly after completing my MSc I began PhD studies in the School of Population and Public Health.

What advice do you have for new graduate students?

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.