Addictions

In British Columbia (BC), it is estimated that 78,000 people are living with hepatitis C virus (HCV), most of whom do not even know they have the disease. If left untreated, HCV can cause serious harm, including liver cancer and death. People who inject drugs (PWID) are at elevated risk of HCV infection given their exposure to various individual and environmental circumstances, such as their ongoing addiction and barriers to accessing health care.

British Columbia (BC) faces a mental health and addiction crisis with an estimated cost of $100 million annually. In April 2016, a public health emergency was declared due to an alarming increase in opioid-related overdose deaths in recent years.

Addiction treatment is critical to addressing the tremendous health and social harms experienced by street-involved youth (SY) with substance use disorders (SUD), including the current fentanyl overdose crisis.

Canada is amid an opioid crisis, with six or seven deaths a day due to opioid overdose. Prescription opioid misuse can also transition to illicit opiate and intravenous drug use, substantially increasing the risk for overdose and blood-borne infections. Rates of overdose death due to counterfeit fentanyl have also risen and represent a growing crisis in most regions in Canada, with British Columbia (BC) being particularly hard hit. Half of the 800 anticipated overdose deaths for 2016 in BC are expected to involve fentanyl.

Dr. Fairbairn's research will:

Opioid use disorder is one of the most challenging forms of addiction facing the health care system in BC and is a major driver of the recent surge in illicit drug overdose deaths in the province. In the context of the current public health emergency, Provincial Health Services Authority agencies the BC Centre for Disease Control (BCCDC) and BC Mental Health & Substance Use Services (BCMHSUS) have identified an urgent need for a policy framework articulating the full range of therapeutic options for the optimal treatment and harm reduction measures those with opioid use disorder.

Substance use disorders account for a significant burden of disease among Canadians and place an enormous burden on the acute care system. The annual cost of harms associated with substance use in Canada is estimated to be approximately $40 billion, with health care being the single largest contributor. In British Columbia (BC) there is clear urgency to address this challenge, given the recent steady increase in hospitalization rates due to substance use and the unprecedented number of drug overdose deaths prompting the recent declaration of a public health emergency.

Hepatitis C (HCV) remains a significant challenge that affects an estimated 60,000 British Columbians. Many more, in particular, people who inject drugs (PWID), remain highly vulnerable to HCV infection. Recently, there have been dramatic developments in the treatment of HCV with the arrival of direct acting antivirals (DAAs). These drug regimens are highly effective, offering vastly superior cure rates over past HCV treatments.

Tobacco, alcohol and other substance use disorders (SUD) are among the most important risk factors for the global burden of disease, with a 38 percent increase in global burden of the disease from substance use in the 20 years between 1990 and 2010, mainly driven by increased drug use (57 percent) and alcohol use (32 percent).

Screening and development of molecules targeting presynaptic SNARE protein-protein interactions as novel pharmacological strategy in schizophrenia and other mental illnesses Schizophrenia is one of the major disabling mental disorders with a worldwide prevalence of about one percent. Although the cause  of schizophrenia remains unclear, converging data indicate that dysfunctions altering neurotransmitter levels in the synaptic cleft, the tiny space between nerve cells in which nerve impulses are conducted, might be at the core of this disorder.

Injection-drug users are extremely susceptible to drug-related health risks, including HIV, hepatitis C and overdose. Although treatments for drug addiction are available, they are not always effective for those with the most severe cases of addiction. A key issue is many members of this vulnerable population remain outside the health care system, which exposes injection-drug users and those in their immediate communities to drug-related health risks.

Motor vehicle crashes cause 15,000 serious injuries and over 2,000 deaths in Canada annually. The contribution of drug-impaired driving to these tragedies is unknown, but suspected to be significant. This lack of knowledge hinders the development of effective traffic safety policies to prevent drug-impaired driving.

The research of Dr. Jeffrey Brubacher aims to prevent injuries and fatalities resulting from motor vehicle crashes. His research program consists of three inter-related themes:

The development of effective HIV/AIDS treatment has resulted in dramatic improvements in the health of people infected with the virus. Taken regularly, highly active antiretroviral therapy (HAART) interrupts the viral life cycle, suppresses the level of HIV in a patient's bloodstream, and promotes health improvements. The recent finding that individuals undergoing effective treatment are far less likely to transmit the virus to others has spurred the development of a new strategy aimed at preventing new HIV infections.