Valerie Nicholson

Battle to beat AIDS offers lessons in fighting opioid crisis

On Vancouver's Downtown Eastside, experts in HIV/AIDS and drug overdose prevention are working together.

When asked what title she’d prefer for this story, Valerie Nicholson laughed and said, “Grandmother, first and foremost.”

It makes everything she explained later all that more powerful.

Nicholson, now a peer researcher with B.C. Centre for Excellence in HIV/AIDS, was homeless and addicted on the streets of Vancouver a decade ago.

Opioid addiction is the current health crisis in B.C. and the rest of Canada, but Nicholson was one of the thousands of Vancouver’s forgotten that were part of another prominent health crisis: the HIV epidemic.

“Addiction can happen to any one of us — it happened to me,” she said. “We can have a tragedy in our life and we go to the easiest coping skill.”

At its worst, HIV/AIDS killed more than 250 people in B.C. in 1994. Illicit drug overdoses, meanwhile, killed a record 914 people in B.C. last year.

So it’s likely no surprise that experts in both medical fields are collaborating. In fact, that is the plan at the Hope to Health Research Clinic.

The new facility, which is set to open in February, will continue the centre for excellence’s world-renowned research on HIV/AIDS and viral hepatitis, as well as substance use and addiction, on Powell Street in the heart of the Downtown Eastside.

Health Minister Terry Lake announced this week the expansion will include a new clinic called Connections, a low-barrier treatment facility set to open in the spring that will offer opioid substitution therapies like Suboxone and Naloxone, which is used to treat opiate overdose.

Dr. Julio Montaner, the man behind the lifesaving anti-retroviral therapy called HAART, will be leading Hope for Health, and Dr. Evan Wood, interim director of the BC Centre on Substance Use, will run Connections.

The clinic is prepared to serve an estimated 200 people per day, and offer personal health care plans for those seeking treatment, while also giving referrals to treatment beds and counselling — services not currently offered at the facility.

Feelings of shame and isolation

HIV-positive and a recovered crystal meth user, Nicholson dealt with the same barriers during the throes of her illness that she imagines opioid addicts face today: a lack of empathy and sympathy — sometimes even from health officials.

“I hear of doctors double-gloving still today,” when treating HIV-positive patients, she said.

Supervised drug injection sites have been a flashpoint for opponents who believe they enable drug users, create concentrated drug-tolerant ghettos and ultimately waste taxpayer money without delivering a lasting solution.

PHOTO: A tow-truck seen in Chilliwack, with a sign that reads “Give Em All Fentanyl.” (Submitted)

One comment sticks with Nicholson from back when she was in the waiting room of a dental office.

She had filled out a form and ticked the box that indicated her HIV status.

As the assistants called others around her, her name was never called and she instead received loud whispers in her direction.

“Everyone else was getting called and I hear them whispering, ‘You know she has HIV. If we ignore her, will she go away?’”

“That put down was enough to keep me down.”

A similar plan of attack

Opioid addition and HIV/AIDS don’t have a lot in common. One is a social disease, while the other is a virus that begins as infection.

But Montaner, who for most of his career has stood at the forefront of HIV treatment innovation, says the two can be tackled the same way: ensuring access to various treatment options.

Many of his clients resisted when he his groundbreaking anti-retroviral therapy, and he said it was important to also be able to offer them nutrition supplements, medical marijuana or drugs that would prevent infection.

To combat the opioid crisis, first responders and social workers in B.C. continue to treat overdoses with naloxone, and access to that medication is expanding.

The next step, he said, is a variety of choices that don’t drive people back to street illegal drugs. Those include methadone, suboxone, and diacetylmorphine, also known as medical-grade heroin.

“While injection drug use or substance use can get you sick and kill you, the illegal drug supply can kill you much faster,” Montaner said. “We can’t change that, but we can change the short-term.”

Montaner is well-known in the HIV/AIDS medical community for his unrelenting passion. And he says it stems from a simple notion: that the ideal is to die of old age.

He says treatment for those addicted to fentanyl and oxycodone, the notion should be no different.

“I will not give up, and that’s what we need to export to the addiction field. We need a holistic system that embraces people the way they are, supports them in their journey so that that then they can make whatever decision for them without pushing them to the illegal drug supply that is going to kill them.”


@ashwadhwaniashley.wadhwani@bpdigital.caLike us on Facebook and follow us on Twitter.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Legion president Al Casswell hands a poppy to Pitt Meadows Mayor Bill Dingwall. (Special to The News)
Legion poppy campaign will start Nov. 1

Maple Ridge’s Legion branch has been raising more than $72,000

Mario Palcich sits atop his 161 pound pumpkin and enjoys a glass of wine. (Special to THE NEWS)
88-year-old Pitt Meadows farmer grows 161-pound pumpkin

Granddaughter goaded Mario Palcich into growing giant gourds

One of the options city council is looking at to reduce greenhouse gases is strengthening development requirements for electric vehicle charging infrastructure. (The News files)
New net zero greenhouse gas emission target for Maple Ridge

City voted to change the target on Oct. 20

There is a case of COVID-19 at Baillie House, located on the grounds of Ridge Meadows Hospital. (Google)
COVID-19 case at Baillie House in Maple Ridge

Seniors facility at Ridge Meadows Hospital one of five with new cases in region

Curtis Sagmoen
Vernon RCMP warn sex workers to stay away from Curtis Sagmoen

RCMP warns workers to stay away from Salmon River Road area

Provincial health officer Dr. Bonnie Henry presents modelling of COVID-19 spread in B.C., March 25, 2020. (B.C. government photo)
B.C. sets another COVID-19 record with 203 new cases

up to 1,766 active cases in B.C., two more deaths

The Vancouver Canucks and Abbotsford’s Jake Virtanen have agreed to a two-year deal with an average annual salary of $2.55 million. (@Canucks Twitter photo)
Abbotsford’s Jake Virtanen, Vancouver Canucks agree to two-year deal

Two sides avoid arbitration, Virtanen will receive average annual salary of $2.55 million

Jordan Naterer, an electrical engineer from Vancouver, was last seen Saturday Oct. 10. (Facebook photo)
Search efforts to resume for missing Manning Park hiker; Trudeau speaks on case

PM says he’ll do what he can to ‘nudge’ efforts to find Jordan Naterer, yet has little leverage locally

Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Join Black Press Media and Do Some Good

Pay it Forward program supports local businesses in their community giving

Smartphone showing various applications to social media services and Google. (Pixabay photo)
National media calling for level playing field with Google, Facebook

In Canada, Google and Facebook control 80 per cent of all online advertising revenues

Swimco announced recently it is shutting all of its stores in Canada, including in Langley. (Swimco website)
Canadian-owned swimsuit chain bankrupt

Swimco had been in creditor protection for several months

École de L’Anse-au-sable. (Google Maps)
B.C. records first COVID-19 outbreak at school, six weeks after students return to class

Three cases of the virus have been identified at École de L’Anse-au-sable

Most Read