Bernadette Pauly's research while affiliated with University of Victoria and other places
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Publications (24)
Background
Illicit drug overdoses have reached unprecedented levels, exacerbated by the COVID-19 pandemic. Responses are needed that address the increasingly potent and unpredictable drug supply with better reach to a wide population at risk for overdose. Drug checking is a potential response offered mainly within existing harm reduction services,...
Aims
Peers, i.e. people with lived/living experience of substance use, are at the forefront of harm reduction initiatives in British Columbia, yet they often lack recognition for their contributions. This study aims to understand the role of peers in overdose response settings and their experiences interacting with emergency service providers (ESPs...
Background
Many communities across North America are coming together to develop comprehensive plans to address and respond to the escalating overdose crisis, largely driven by an increasingly toxic unregulated drug supply. As there is a need to build capacity for successful implementation, the objective of our mixed methods study was to identify th...
Background
Drug prohibition has been associated with increased risk of overdose. However, drug prohibition remains the dominant drug policy, including in Canada with the Controlled Drugs and Substances Act. In 2017, the Good Samaritan Drug Overdose Act (GSDOA) was enacted, to encourage people to contact emergency medical services by providing bysta...
This research explored drug checking as a market intervention with a potential role in supporting a safer supply within the overdose crisis. We sought the perspectives of potential service users, including those who sell substances. Twenty-six semi-structured interviews were conducted in Victoria, British Columbia (BC), Canada with research guided...
Background
Hospital patients who use drugs may require prolonged parenteral antimicrobial therapy administered through a vascular access device (VAD). Clinicians’ concerns that patients may inject drugs into these devices are well documented. However, the perspectives of patients on VAD injecting are not well described, hindering the development of...
Plain English Summary In Canada, one of the lessons being learned as we navigate the current dual public health crises (COVID-19 pandemic and illicit drug overdoses and deaths) is the extent to which substance use and access to services is highly stigmatized, especially when combined with poverty, homelessness and perpetuated by racism and other fo...
The COVID-19 pandemic is exacerbating longstanding issues related to homelessness, including lack of affordable housing, unemployment, poverty, wealth inequality, and ongoing impacts of colonization. Homelessness is often accompanied by narratives rooted in individual blame, criminalization, and reinforcement of substance use and mental health-rela...
Background
The drug toxicity crisis has had dramatic impacts upon communities of people who use substances. Peer workers, individuals with lived/living experience of substance use who work in overdose response settings, are particularly susceptible to negative impacts on wellbeing caused by this crisis. Coupled with the devastating effects of the C...
Objective:
The purpose of this scoping review was to systematically identify and describe literature that uses a health equity-oriented approach for preventing and reducing the harms of stigma or overdose for people who use illicit drugs or misuse prescription opioids.
Inclusion criteria:
To be included, papers had to both: i) use a health equit...
Background
As drug checking becomes more integrated within public health responses to the overdose crisis, and potentially more institutionalized, there is value in critically questioning the impacts of drug checking as a harm reduction response.
Methods
As part of a pilot project to implement community drug checking in Victoria, BC, Canada, in-de...
Background
Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental...
Background
People who use substances experience high levels of substance-related stigma, both within and outside of health care settings, which can prevent people from help-seeking and contribute further to health inequities. Recognizing and respecting how political, social, economic, and historical conditions influence health and health care, cult...
First recognized in December 2019, the Coronavirus Disease 2019 (COVID19) was declared a global pandemic by the World Health Organization on March 11, 2020. To date, the most utilized definition of ‘most at risk’ for COVID19 morbidity and mortality has focused on biological susceptibility to the virus. This paper argues that this dominant biomedica...
Background
Experiential workers or ‘peers’ (workers with past or present drug use experience) are at the forefront of overdose response initiatives and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for experiential workers but is also stressful, with lasting emoti...
Background: Peer workers or ‘peers’ (workers with past or present drug use experience) are at the forefront of overdose response initiatives and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental...
The primary objective of this study was to examine the impacts associated with implementation of overdose preventions sites (OPSs) in Victoria, Canada during a declared provincial public health overdose emergency. A rapid case study design was employed with three OPSs constituting the cases. Data were collected through semi-structured interviews wi...
Background: Managed alcohol programs are a harm reduction approach for people with severe alcohol use disorder that provide alcohol in a structured setting. We examined the patient experience of receiving alcohol after the implementation of a hospital-based managed alcohol program.
Methods: Using an interpretative descriptive methodology, we conduc...
Homelessness has negative implications for mental well-being and quality of life. This paper identifies the quality of life variables that contribute to positive or negative wellbeing, reporting on a regression analysis from 343 individuals experiencing homelessness in Canada. Results indicate that a lack of sleep duration and quality reduced menta...
Patient-oriented research (POR) aims to increase patient engagement in health research to improve health research and health services. In Canada, the Strategies for Patient-Oriented Research (SPOR) framework provides guidance for conducting POR. We critically review the SPOR framework through the lens of public health systems and services research....
Citations
... Improving the relationship between PWUD and the 911 system must begin with and be sustained by the ethical engagement with PWUD in service design and delivery. It should be acknowledged that in some areas, due to delayed wait times and other complicating contributors, the relationship between PWUD and the 911 system is strained (68). The importance of the paramedic role in caring for PWUD however will simply not be fully realized without this collaborative approach. ...
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... Last, perceived control indicates an actor's belief that the potential behavior is under their control, and may be compared to the related concepts of locus of control or self-efficacy.In qualitative research, PWUDs often endorse the importance of saving lives by calling 911 when witnessing overdoses,10,13 suggesting that subjective norms are appropriately aligned with health outcomes. However, they frequently decline to call 911 due to fear of LEO interactions,50,69 or, when doing so, leave the scene of the emergency or relocate the overdosed person to a public place to avoid interactions with LEOs.10 Many GSLs and other harm-reduction policies may not have sufficiently changed attitudes regarding outcomes of LEO interactions.50 ...
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... Encampments are met with varied community responses from community sweeps and displacement with or without supports to tacit acceptance and/ or in a few cases sanctioning (Cohen et al., 2019). Public controversies surrounding visible encampments are often closely intertwined with discussions of public health and public safety including lack of sanitation and increasing crime as reasons for displacement (Lorinc, 2020;Olson & Pauly, 2021). These discussions take place in a political and policy landscape that displaces and/or criminalizes people for acts of living such as eating, sleeping, and performing bodily functions in public amidst lack of access to basic public health infrastructure and safe, acceptable, and affordable housing for living (Rankin, 2019(Rankin, , 2020. ...
... The JBI is an international organization based at the University of Adelaide (Australia); it comprises a network of health scientists, professionals, researchers, and students committed to health practices based on reliable scientific evidence (12,13). This organization aims to improve health outcomes through scientific production, training, and dissemination (14). ...
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... The disproportionate impacts of overdose are well documented with overdoses impacting all sectors of the population [16,31,43]. However, equity-oriented responses to overdoses are lacking, particularly equityoriented services which are contextually tailored to the varied sociopolitical contexts in which people use drugs [49]. ...
... Communications that offer specific, actionable descriptions and insights about known substances of concern (and/or reported harms) can facilitate rapid dissemination of relevant education, prevention, and advice to promote awareness of perceived threats and widespread information exchange to help reduce the impact of adverse events [17,49]. However, in the current context of prohibition, criminalisation, and stigmatisation of people who use drugs, widescale public health initiatives have historically been overshadowed by the prioritisation of law enforcement approaches, resulting in reactive rather than preventative resource allocation for proactive health and harm reduction interventions [1,52]. ...
... This "under-the-radar" caregiving is resulting in significant levels of stress, role strain, and a "shadow epidemic" of compounding grief and distress, impacting their capacity to provide needed palliative care. 18,[20][21][22][23] Although little research focusses on the end-of-life context, evidence indicates that witnessing numerous unjust and preventable deaths (e.g. overdose response setting) results in workers experiencing levels of grief and distress similar to emergency responders. ...
... Participants identified feelings of fear and embarrassment when accessing or considering accessing drug checking sites, especially where community drug checking is viewed as an inner-city service within a non-governmental organization serving a clientele assumed to use drugs. However, cultural safety for people who use drugs varies and accessibility for some may be inaccessibility for others [43]. Fear of association with these types of services may be rooted in structural stigma as well as a hierarchy of substances identified by some of the participants. ...
... Different studies have been carried out for risk assessment or decision-making regarding COVID-19 in which advice to prioritize populations with social conditions is necessary for more effective control of the epidemic in its next phase and should become the norm in the planning, prevention, and mitigation of all health problems [12,13]. In this context, Twitter has been widely used for studies relating to the COVID-19 pandemic vaccine [14,15]. ...
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... Although the concept is still within its infancy, harm reduction strategies on hospital grounds have begun to start up in Canada. A supervised consumption service (33) and a bedside needle/syringe program (34) in Edmonton as well as overdose prevention programs in Vancouver (35) and Victoria (36) have been implemented. Free naloxone kits have also been made available to patients at two hospital emergency departments in Toronto (37). ...
