Kanna Hayashi | Harm Reduction in an Unprecedented Overdose Crisis

PFL 2021-2022, Equity + Justice, 2022, Health, President's Faculty Lectures

The ongoing drug toxicity crisis, declared as a public health emergency in British Columbia in 2016, has been severely exacerbated during the COVID-19 pandemic in 2020 and continues to take a serious toll on our communities. In order to address this unprecedented overdose crisis, a range of harm reduction interventions (both existing and new) that are grounded in people’s lived experiences, scientific evidence and health equity are desperately needed, now more than ever. This lecture briefly introduced harm reduction, presented some harm reduction interventions that have been done in B.C., and discussed what still needs to be done.

— Kanna Hayashi

Wed, 02 Mar 2022

Djavad Mowafaghian World Art Centre

SFU Goldcorp Centre for the Arts
149 West Hastings Street
Vancouver, B.C.

The President's Faculty Lectures

The President’s Faculty Lectures shine a light on the research excellence at Simon Fraser University. Hosted by SFU president Joy Johnson, these free public lectures celebrate cutting-edge research and faculty that engage with communities and mobilize knowledge to make real-world impacts.

Each short lecture by an SFU researcher will be followed by a conversation with Joy Johnson and an audience Q&A session livestreamed from the Djavad Mowafaghian World Art Centre at SFU’s Goldcorp Centre for the Arts.

This year, lecturers will approach the themes of equity and justice from a variety of disciplines.

Kanna Hayashi

Kanna Hayashi is a substance use epidemiologist, the St. Paul’s Hospital Chair in Substance Use Research, and an assistant professor at SFU’s Faculty of Health Sciences. She is also a research scientist at the BC Centre on Substance Use and a Michael Smith Foundation for Health Research Scholar. She leads the Vancouver Injection Drug Users Study (VIDUS), a long-running study that operates in Vancouver’s Downtown Eastside neighbourhood and follows over 1,000 people who inject drugs. Her research aims to inform public health-oriented approaches to laws, policies and programs and thereby reduce drug-related harm among people who use drugs.



Event summary

Recap of Harm Reduction in an Unprecedented Overdose Crisis with Kanna Hayashi

By Sam Robinson, MA, SFU Department of Gender, Sexuality & Women's Studies

Dr. Kanna Hayashi is a substance use epidemiologist currently leading the Vancouver Injection Drug Users Study (VIDUS), while also serving as the St. Paul’s Hospital Chair in Substance Use Research and as an assistant professor at Simon Fraser University. In the fifth installment of the 2021/2022 President’s Faculty Lectures, hosted by SFU Public Square, Dr. Hayashi discussed the current overdose crisis through looking at harm reduction and harm reduction policies, both present and future. 

To begin, SFU President Joy Johnson opened the event with an acknowledgement that these lectures take place on the unceded territory of the Sḵwx̱wú7mesh Úxwumixw (Squamish), səl̓ilw̓ətaʔɬ (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations. Dr. Hayashi opened her talk with a similar acknowledgement, adding that most of her research findings were conducted on this unceded land as well.

Dr. Hayashi began her lecture with a brief overview of her own research history, allowing her to tie her history into her belief in a social epistemological approach to research. This approach implores researchers to focus not only on the individual factors associated with health, but also on the impact of social structures such as race, gender and socioeconomic status.

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The pandemic has exacerbated an already existing overdose crisis—one we are over five years into as of now. In 2021, Dr. Hayashi explained, we were losing an average of six people a day to drug toxicity. The severity of this number was not understated. But how do we tackle this crisis? Dr. Hayashi suggests we need a combination of treatment and recovery support as well as harm reduction policies, and that focusing on only one is not enough. 

Following this, Dr. Hayashi explained what harm reduction is, adding that her aim was to make her presentation and findings accessible to as wide an audience as possible. In her words, harm reduction is any policies, programs and/or practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. She stresses that the most important part of this definition is that it serves those who are continuing drug users for any reason without expecting or guiding them to stop their use. Instead, the focus is solely on reducing the harm associated with their use and protecting their health.

Dr. Hayashi then pivoted to sharing some of the harm reduction policies and programs currently being offered in Vancouver. She shares that she considers B.C. a leader in harm reduction practices, due to its history and present of strong community activism, especially in Vancouver’s Downtown Eastside. Some examples of these programs include needle exchange programs, supervised injection sites, drug checking programs, naloxone distribution, overdose prevention sites, and expansion of opioid agonist therapy. These programs have contributed to several positive changes, such as increased attendance to supervised injection and overdose prevention sites, increased treatment participation, and decreases in needle sharing and public drug injections. 

But why, Dr. Hayashi asks us, is the overdose crisis worse now? The answer, quite simply, is COVID-19. She explains that with the pandemic closing borders, unregulated street drugs became more toxic due to changes in how and where drugs were trafficked. As well, pandemic closures resulted in lack of access to services and disrupted peer networks. The result of this was that drug users’ needs were unmet, and overdoses skyrocketed. 

As the final portion of her lecture, Dr. Hayashi discussed her recommendations for future harm reduction strategies, specifically framing them to address the places COVID-19 exacerbated already existing gaps in support. Her largest finding is that opioid agonist therapy (OAT) is not serving the purpose it needs to. In brief, OAT is a harm reduction program where primary care physicians prescribe opioids. It is considered the current gold standard in opioid addiction treatment. But COVID-19 made it harder to talk to primary care physicians, resulting in a lack of access to opioids. This impacted 19 per cent of people in Vancouver who were on OAT in 2020. As well, 23 per cent of Vancouver drug users studied were already avoiding health care due to prior mistreatment by health care practitioners. Adding to that, now that we are in year five of the overdose crisis, Dr. Hayashi believes that people’s tolerance for opioids has changed and that the drugs provided through OAT may not be strong enough. 

Therefore, Dr. Hayashi suggests a novel harm reduction approach: prescribed safer supply. Approved by the B.C. government in July 2021, this is Canada’s first permanent safer drug supply initiative and will provide pharmaceutical alternatives to street drugs for the purpose of preventing overdoses. The VIDUS project will evaluate how this approach does in this regard as the program is rolled out. Dr. Hayashi also stressed the importance of community-led safer supply—again highlighting the value of meeting the needs of drug users who are distrustful of medical clinics. 

Finally, Dr. Hayashi ended her lecture by emphasizing the impact of broader issues in contributing to the overdose crisis, such as misogyny, racism, poverty, childhood trauma and the housing crisis, and stating that these are the things we also need to tackle if we wish to engage in truly comprehensive harm reduction work.

2021/2022 President's Faculty Lectures

  • Wendy Hui Kyong Chun | Discriminating Data

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    In this President's Faculty Lecture, Wendy Hui Kyong Chun (SFU's Canada 150 Research Chair in New Media) discusses themes from her forthcoming book Discriminating Data about how big data and predictive machine learning currently encode discrimination and create agitated clusters of comforting rage.

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  • Tammara Soma | Setting the Table for Food Justice

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    When it comes to issues like food insecurity, who gets to shape the solutions? Tammara Soma will share how SFU's Food Systems Lab applies community-engaged research methods to achieving sustainable, decolonized and just food systems for all.

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  • Taco Niet | Just Climate Policies

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    How do we address the climate crisis effectively and equitably? Taco Niet of SFU’s School of Sustainable Energy Engineering will discuss how evidence-based modelling tools are essential for making urgent climate policy decisions grounded in justice and equity.

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  • Vaibhav Saria | Care and Crisis in India

    PFL 2021-2022, Equity + Justice, 2022, Health, President's Faculty Lectures

    Vaibhav Saria, assistant professor of gender, sexuality and women’s studies at SFU, will explore how the complex history of health care in India has led to a valorization of care providers’ work during COVID-19, but also to increased violence against them.

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  • Kanna Hayashi | Harm Reduction in an Unprecedented Overdose Crisis

    PFL 2021-2022, Equity + Justice, 2022, Health, President's Faculty Lectures

    Kanna Hayashi, the St. Paul’s Hospital Chair in Substance Use Research, will explain how harm reduction interventions grounded in lived experiences, scientific evidence and health equity are desperately needed to address B.C.’s unprecedented drug toxicity crisis.

    Read More →

  • June Francis | Becoming an Anti-Racist, Decolonized University

    PFL 2021-2022, Equity + Justice, 2022, President's Faculty Lectures

    June Francis, director of the SFU Institute for Diaspora Research & Engagement, will challenge whether traditional universities, which have been key pillars in constructing racism, are prepared to truly decolonize and become anti-racist.

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Past President's Faculty Lectures