Foundry goes “Boots on Ground” to battle opioid crisis

The waiting room of Foundry’s Granville Street location is awash with cheerful, bright colours, but just below the surface there is anguish.

“We’ve lost so many clients,” says Keren Mitchell, nurse practitioner. “We build close relationships with the youth in our programs, so it’s been a really difficult time for the staff here.”

There were 382 deaths in the City of Vancouver from opioids in 2018. It’s not just lives that are lost; many who survive their overdoses are left with significant, life-limiting brain injuries. This crisis has highlighted the need to step out of the box and do things differently.

Providence is the host organization for Foundry, which provides a one-stop-shop for young people to access mental health care, substance use services, primary care and more. Its model founded on the St. Paul’s Youth Mental Health Initiative and has grown into a province-wide network.

In February 2018, the team introduced Microdose Mondays, which uses a microdose protocol to initiate on-the-spot, regular dosing of Suboxone in youth with significant barriers to induction, such as homelessness, psychosis or developmental disabilities.

Microdose induction involves introducing a very low dose of Suboxone and gradually increasing it over five to seven days, thereby allowing the brain to adjust without precipitating withdrawal. As the Microdose Monday project progressed, the team added other forms of Opiate Agonist Therapy (OAT) and additional interventions to support youth with adherence.

In February of this year, the team launched a program called OATreach for Foundry clients who are living at the St. Helen’s Hotel who have an opioid use disorder. St. Helen’s, operated by COAST Mental Health, offers low-barrier housing to youth, many of whom are right off the street. The Foundry team employs a variety of hands-on outreach methods to initiate relationships and build trust.

“Youth are very vulnerable, but they’re also incredibly resilient,” says Keren. “Recovery looks different for everyone, but OAT can provide these young adults with a chance to stabilize and connect with care providers, as well as with their family and friends.”