Dr. Geoff Bardwell
Assistant Professor, School of Public Health Sciences at University of Waterloo
Dr. Geoff Bardwell, PhD, is an Assistant Professor in the School of Public Health Sciences at University of Waterloo and a Research Scientist at the BC Centre on Substance Use. He is a qualitative and community-based researcher who focuses on unregulated drug use and related drug policies and public health interventions, primarily in small urban, rural, remote, and Indigenous communities. His research has informed policy and programmatic changes at organizational, municipal, and provincial levels. Prior completing his PhD, Dr. Bardwell worked a variety of direct service roles with people who use drugs including street outreach and housing stability positions. You can read more about him here.
Presentation & Slides
Presentation slides above provided by Dr. Geoff Bardwell
On June 1st, 2023 host Regional Councillor Rob Deutschmann held this virtual conversation focused on Waterloo Region's drug-related crisis.
Expert guest speakers, including Dr. Geoff Bardwell, outlined key aspects of the drug poisoning crisis we face in Waterloo Region, opportunities to improve our local prevention and response measures, and their visions for a safer and healthier community.
“There is so much publicly-available data on issues related to the drug poisoning crisis in the Region. What is missing is a clear strategy and the political will to address the deadliest public health crisis of our time. We saw how swift governments responded to COVID-19, so where is the same level of urgency for the overdose epidemic?"
- Dr. Geoff Bardwell
Geoff, who recently moved from British Columbia to become an assistant professor at the University of Waterloo's School of Public Health Sciences, gave a detailed presentation on the role of research and publicly available data in understanding and addressing opioid-related deaths in the Waterloo region.
To begin, Geoff emphasized the importance of looking at per-capita rates when examining opioid-related deaths. He argued that understanding the distribution and rate of deaths allows for a clearer perspective on the impact of the opioid crisis on different communities. However, he reminded his audience that it's essential not to reduce the issue merely to statistics, acknowledging that each data point represents a human life.
One of the most significant points Geoff raised was challenging the common perception that overdose deaths are primarily a street-level issue, affecting mainly homeless or destitute individuals. Data from Ontario showed that most overdoses occur indoors, with a majority happening within private residences. This revelation underscores the necessity of interventions that target housing environments. Geoff presented several innovative solutions he encountered during his work in British Columbia, such as tenant-led Naloxone training and distribution programs, integrated supervised consumption spaces within housing facilities, supportive housing with primary care clinics, in-reach programs, and the provision of safer opioid supplies.
Geoff then focused on the methods of drug consumption responsible for the majority of overdoses in Waterloo region. He pointed out a clear upward trend in inhalation-related overdoses and a concurrent downward trend in injection-related overdoses since 2019. This data suggests that public health interventions, traditionally focused on injection drug use, must be restructured to account for inhalation drug use. Potential strategies include increased education and awareness around the risks associated with drug inhalation, reimagining supervised consumption services to accommodate inhalation, and considering the use of smokable opioid agonist treatments, which have had success during trials conducted in the Netherlands.
Geoff also addressed the need for local and region-specific strategies. He warned against the assumption that interventions successful in large urban areas like Toronto could be directly transplanted to smaller or rural communities. Geoff discussed his research in British Columbia, where he identified several unique challenges in rural areas, such as transportation issues, heightened stigma due to close-knit communities, privacy and confidentiality concerns, a lack of availability of some services, and increased distances to treatment and health services. He stressed that local clinicians might also lack adequate education and training in substance use treatment due to the smaller size of these communities.
- Targeted interventions in housing environments, owing to data that shows most overdoses happen indoors and in private residences.
- This trend suggests that public health interventions must be revised to account for inhalation drug use.
- What works in large urban areas might not suit smaller communities or rural areas.