Over half of British Columbians who died from opioid poisoning had visited an emergency department (ED) in the year before their death, and 1 in 5 left against medical advice before completing treatment. EDs are a critical setting for starting opioid-related care and connecting people to community services. Yet current measures track mostly system-defined outcomes: whether treatment began, a referral was made, or an overdose recurred. They say little about outcomes that matter to people receiving care.
Peers work at the interface between ED and community care, in roles spanning relationship-building, emotional support, navigation, health promotion, and advocacy — functions that bridge fragmented systems. Supporting many people across that gap, peers see where the pathway holds and where it breaks down. PWLLE bring the other half of the picture: having moved through ED-initiated opioid care themselves, they know what felt safe, supportive, or disconnected. Together, they describe both recurring patterns and the lived experience of moving through the pathway.
This project focuses on Island Health. Island Health fits well: a peer co-lead in the region, established peer relationships, and alignment with its Addiction Medicine and Substance Use portfolio. This regional focus allows deeper trust-building while drawing on diverse communities and care settings.
We will hold two virtual sessions, each about 2 hours long, between September and November 2026. Given the sensitive subject matter, PWLLE participants will be offered optional one-to-one conversations beforehand. Each session will bring together 8-10 participants: PWLLE, peers, community addiction and peer providers, emergency clinicians, and health system partners. The sessions are new, project-specific activities and separate from regular Peer Community of Practice meetings. Session 1 will explore experiences across ED and community care, including where transitions feel supportive, safe, or disconnected. Session 2 will identify peer- and PWLLE-informed outcomes and priorities for future work.
By the end we will have: (1) strengthened relationships among peers, PWLLE, clinicians, community partners, and researchers; (2) built a shared understanding of experiences and priorities in opioid-related ED and community care; and (3) produced a peer- and PWLLE-informed briefing note on meaningful outcomes, transition priorities, and directions for strengthening ED-to-community opioid care in Island Health.
Additional team members and participating organizations:
Key collaborators
People with lived and living experience; peer support workers; emergency clinicians; and community-based addiction and peer support providers across the Island Health region
Participating organizations
Department of Emergency Medicine, University of British Columbia
Emergency Care BC
Island Health