Implementing a new model of substance use care in British Columbia: healthcare staff experiences from the road to recovery initiative
6 affiliations
- 1British Columbia Centre on Substance Use, 400-1045 Howe St., Vancouver, BC V6Z 2A9 Canada
- 2Faculty of Science, University of Southern California, Zonal Avenue, Biggy Street, Los Angeles, CA 90033 USA
- 3Division of Social Medicine, Department of Medicine, University of British Columbia, 327-2194 Health Sciences Mall, Vancouver, BC V9T 1Z3 Canada
- 4Interdepartmental Division of Addiction, Providence Health Care, 1081 Burrard St., Vancouver, BC V6Z 1Y6 Canada
- 5Department of Medicine, University of British Columbia, 327-2194, Health Sciences Mall, Vancouver, BC V9T 1Z3 Canada
- 6Indigenous Wellness and Reconciliation Team, Providence Health Care, 1081 Burrard St., Vancouver, BC V6Z 1Y6 Canada
Abstract
Background: To address the increasingly potent unregulated drug supply and the complex withdrawal syndromes that accompany it, a hospital-based withdrawal management unit was launched in September 2023 as part of Vancouver, Canada’s Road to Recovery (R2R) initiative. This study explores healthcare staff experiences working within the new unit to identify opportunities to improve clinical service delivery and working conditions.
Methods: This study employed a mixed method design. Between May and July 2024, R2R healthcare staff were invited to complete a cross-sectional survey to characterize their experiences working in a new hospital-based withdrawal management unit. A purposive sample of healthcare staff were selected to complete a one-time semi-structured qualitative interview between July and August 2024. Descriptive statistics were used to summarize survey data, while conventional content analysis was used to analyze qualitative data.
Results: Thirty-three healthcare staff completed the study’s cross-sectional survey, including clinicians (e.g., nurses, physicians, pharmacists) and other staff such as social workers, peer support specialists, and Indigenous Wellness Liaisons (IWLs). Overall, 97% (n = 32) reported feeling satisfied with their role at R2R. Most respondents felt the model of care was well-rounded (82%, n = 27), trauma-informed (82%, n = 27), culturally and spiritually sensitive (85%, n = 28), and safe (94%, n = 31). Qualitative interviews (n = 8) revealed a consistent sense of pride in delivering ‘recovery-oriented’ care. Participants also felt R2R care provision was individualized, high-quality, and promoted meaningful engagement with patients through the cultivation of a safe environment. Job satisfaction was linked with feeling autonomous in providing patients access to a comprehensive spectrum of substance use services. Integration of traditional healing practices, as well as the incorporation of unique provider roles including peer support specialists and IWLs were identified as unique factors contributing to positive work experiences. Areas identified to be challenges included overly rigid approaches to patient care following relapses to substance use, as well as ongoing shortages of experienced, culturally safe healthcare staff, contributing to capacity constraints and burnout in the midst of the ongoing toxic drug crisis.
Conclusions: Overall, healthcare staff reported job satisfaction working in a new hospital-based withdrawal management unit. Furthermore, participants described the R2R model of care as comprehensive, trauma-informed, and culturally safe.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13722-026-00705-y.
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BibTeX
@article{abramowich2026implementing,
title = {{Implementing a new model of substance use care in British Columbia: healthcare staff experiences from the road to recovery initiative}},
author = {Ava Abramowich and Piper Dickhout and Seonaid Nolan and Cameron R. Eekhoudt and Sidney Roberge and Travis De Wolfe and Erika Mundel and Renée M. Janssen and Andrea Ryan and Cheyenne Johnson and Laurel Lemchuk-Favel and Harmony Johnson and Jeanette M. Bowles and Brittany B. Dennis},
journal = {Addiction Science \& Clinical Practice},
year = {2026},
month = aug,
doi = {10.1186/s13722-026-00705-y},
url = {https://doi.org/10.1186/s13722-026-00705-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Implementing a new model of substance use care in British Columbia: healthcare staff experiences from the road to recovery initiative
AU - Ava Abramowich
AU - Piper Dickhout
AU - Seonaid Nolan
AU - Cameron R. Eekhoudt
AU - Sidney Roberge
AU - Travis De Wolfe
AU - Erika Mundel
AU - Renée M. Janssen
AU - Andrea Ryan
AU - Cheyenne Johnson
AU - Laurel Lemchuk-Favel
AU - Harmony Johnson
AU - Jeanette M. Bowles
AU - Brittany B. Dennis
PY - 2026
DA - 2026/08/06
JO - Addiction Science & Clinical Practice
DO - 10.1186/s13722-026-00705-y
UR - https://doi.org/10.1186/s13722-026-00705-y
AB - Background: To address the increasingly potent unregulated drug supply and the complex withdrawal syndromes that accompany it, a hospital-based withdrawal management unit was launched in September 2023 as part of Vancouver, Canada’s Road to Recovery (R2R) initiative. This study explores healthcare staff experiences working within the new unit to identify opportunities to improve clinical service delivery and working conditions. Methods: This study employed a mixed method design. Between May and July 2024, R2R healthcare staff were invited to complete a cross-sectional survey to characterize their experiences working in a new hospital-based withdrawal management unit. A purposive sample of healthcare staff were selected to complete a one-time semi-structured qualitative interview between July and August 2024. Descriptive statistics were used to summarize survey data, while conventional content analysis was used to analyze qualitative data. Results: Thirty-three healthcare staff completed the study’s cross-sectional survey, including clinicians (e.g., nurses, physicians, pharmacists) and other staff such as social workers, peer support specialists, and Indigenous Wellness Liaisons (IWLs). Overall, 97% (n = 32) reported feeling satisfied with their role at R2R. Most respondents felt the model of care was well-rounded (82%, n = 27), trauma-informed (82%, n = 27), culturally and spiritually sensitive (85%, n = 28), and safe (94%, n = 31). Qualitative interviews (n = 8) revealed a consistent sense of pride in delivering ‘recovery-oriented’ care. Participants also felt R2R care provision was individualized, high-quality, and promoted meaningful engagement with patients through the cultivation of a safe environment. Job satisfaction was linked with feeling autonomous in providing patients access to a comprehensive spectrum of substance use services. Integration of traditional healing practices, as well as the incorporation of unique provider roles including peer support specialists and IWLs were identified as unique factors contributing to positive work experiences. Areas identified to be challenges included overly rigid approaches to patient care following relapses to substance use, as well as ongoing shortages of experienced, culturally safe healthcare staff, contributing to capacity constraints and burnout in the midst of the ongoing toxic drug crisis. Conclusions: Overall, healthcare staff reported job satisfaction working in a new hospital-based withdrawal management unit. Furthermore, participants described the R2R model of care as comprehensive, trauma-informed, and culturally safe. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13722-026-00705-y.
SN - 1940-0632
SN - 1940-0640
ER -