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.

Just Posted

VIDEO: 5X Festival takes over Surrey’s Central City plaza

Second annual event draws thousands of people throughout the day

The struggle for space inside Surrey’s elementary schools

SECOND IN A SERIES: A look at how overcrowding impacts student life

City shifts proposed transit station to King George after cancellation of LRT

Council to consider Newton Town Centre plan in fall

VIDEO: Plane makes forced landing on Highway 17 in Surrey

Police say no one was injured and no damage to aircraft or vehicles

Nearly 200 motorcycles take off from Cloverdale for Brenden’s Ride

Annual fundraiser supports programs that empower people with disabilities

10 facts about Father’s Day

Did you know that the special day for dads was first celebrated in 1910?

Bombers down B.C. Lions 33-23 in season opener

Former Lion Andrew Harris leads Winnipeg with 148 rushing yards

Northern B.C. family remembers murdered Indigenous woman with memorial walk

Still no closure for Ramona Wilson’s family 25 years later

Pride flag taken down by Township of Langley

Woman said she was told it was removed from her front yard because of a complaint

B.C. university to offer mentorship program for former youth in care

Students using the provincial tuition waiver program will soon be able to form a community at KPU

Cyclists competing in one of the toughest bike races on the planet pass through Fernie

Divide riders looking strong as they finish first leg of 4160 km race

You might not know these B.C. records are public

Hired a lawyer to file a civil claim? Those are published online

B.C. bus driver loses case to get job back after texting while driving full bus

An arbitator ruled that Tim Wesman’s phone usage was a “a reckless disregard for public safety”

Revamped B.C. Lions set to battle veteran Winnipeg Blue Bombers

The Lions’ first test of the season will be a big one

Most Read