Love, respect and dignity: How one graduate is addressing the opioid crisis

"Harm reduction can improve the health of any Canadian who struggles with substance use and can help reduce stigma."

Rachel Harper - 20 November 2018

Hannah Brooks was a long way from her hometown of Nashville, Tennessee when she discovered her passion. Having graduated with her bachelor's degree in international relations during the recession and realizing jobs were tough to come by in the United States, Brooks made her way to Kyrgyzstan to teach English.

"While I was living in Kyrgyzstan, I saw many health inequities and I knew pursuing a degree in public health was the next step I wanted to take," says Brooks, recent master of science (MSc) graduate. "But I wanted to get experience working in public health before I applied."

Brooks did just that. She taught English in the evenings to support herself financially, but during the day she did public health internships. In the morning, she worked with children with disabilities and in the afternoon she worked at the United Nations Development Programme (UNDP) Global Fund Partnership. But there was one memorable project at the UNDP that ignited her passion for helping the most vulnerable.

"I had the opportunity to work in a shelter for women who injected drugs," explains Brooks. "I had the privilege of meeting them, learning about their stories and hearing about their experiences. Some of these women were also sex workers. It was truly eye-opening to see how the stigma they faced negatively affected their lives."

Brooks saw that stigma prevented these women from gaining access to health care, housing, jobs and fundamental ways to improve their circumstances. For her, it didn't seem right.

"I got to know them and they were completely normal women; they just happened to have circumstances in life that led them to use drugs or work on the streets," says Brooks. "I knew their situation could change if that stigma was removed. I knew I wanted to be part of that change."

Brooks returned to the United States and began applying for graduate schools. She was drawn to the University of Alberta's School of Public Health because of its accreditation by the Council on Education for Public Health, its high-quality educational programs and its location in the city of Edmonton.

Formerly in the master of public health program specializing in global health, Brooks switched to an MSc in general public health after meeting Elaine Hyshka, assistant professor, during her practicum.

"It was clear from the beginning that I was interested in working with individuals involved in either sex work or substance use because I knew they faced a lot of stigmas," says Brooks. "After meeting Elaine, I saw how motivated and passionate she was about substance use and harm reduction. She is a leader in her field, and I saw that I could learn a lot from her and make a difference."

For her thesis, Brooks interviewed 25 patients at the Royal Alexandra Hospital who were utilizing the needle and syringe program provided by the Inner City Health and Wellness Program's Addiction Recovery and Community Health (ARCH) team. Through these interviews, she wanted to understand their experiences injecting drugs while hospitalized, what it was like receiving care, and their thoughts on the program and how it could be improved.

"Needle and syringe programs are one part of the harm reduction model. For many people, it is unrealistic and unhealthy to stop using while you're hospitalized, so these programs offer free, sterile supplies for people who inject drugs," says Brooks. "Ideally, this will create an option where they can inject safely, are treated respectfully and are provided with tools and supports to meet them where they're at on their substance use journey."

Brooks found that patients had a variety of negative and positive experiences while being part of the program and has made recommendations for three main modifications to the needle and syringe program. They include: increasing awareness about the program, providing patients with a safe environment within the hospital where they can inject drugs and access supplies, and communicating clearly with patients about how their experience might change if they participate in the program.

Now graduated, Brooks will be staying in Edmonton working as a data coordinator with the Royal Alexandra Hospital's Inner City Health and Wellness Program. She will continue following her passion by managing the data collection for Edmonton's community supervised consumption sites. Her role includes coordinating and analyzing data for the three community sites, ensuring data integrity and reporting findings back to the Government of Alberta.

"We are currently experiencing an opioid crisis in Canada, and it's important to remember that this doesn't just affect people living on the streets-it can affect everyone," explains Brooks. "People use drugs for many reasons and simply telling someone to stop doing so is not realistic, and it simply doesn't work for everyone. This is why harm reduction is important. It can improve the health of any Canadian who struggles with substance use and helps reduce stigma."

"It's about treating people with love, respect and dignity. I'm excited to be part of that."

In addition to earning her MSc degree in general public health, Hannah Brooks is the first graduate in the School to receive a graduate certificate in communicable diseases. This certificate aims to complement and build on the training of master's level graduate students.