Research evaluation helps shape the future of addiction treatment in BC

The Road to Recovery (R2R) program, a new model of substance use treatment, is helping to shape the future of addiction care across B.C. Co-led by Dr. Brittany Dennis, Clinician-Scientist, BC Centre on Substance Use (BCCSU), and Dr. Seonaid Nolan, Division Head, Interdepartmental Division of Addiction, Providence Health Care (PHC), an evaluation of this program was enabled by the Carraresi Foundation Early Career Clinician Investigator Award. 

Dr. Dennis, who is also an attending physician at St. Paul’s Hospital and an Assistant Professor in the University of British Columbia’s (UBC) Department of Medicine, was one of the 2023 winners of the award, which provides funding for early-career investigators to pursue research projects. Her funded study is designed to assess the efficacy of the R2R, and generate data to support the expansion of evidence-informed, coordinated substance use care throughout the province.  

Evaluating a new model of substance use care 

First piloted at PHC in 2023, R2R is designed to address critical gaps in addiction treatment by integrating services and expanding capacity. Developed in collaboration with the BCCSU, the PHC Indigenous Wellness and Reconciliation Team, the B.C. Ministry of Health, and Vancouver Coastal Health, the program aims to provide seamless access to care throughout every stage of recovery, providing services including withdrawal management, stabilization and transitional care, and long-term recovery support.   

Amid a toxic drug crisis that has made withdrawal treatment increasingly complex, the R2R program aims to create a new standard of care for patients with substance use disorders by providing access to key services and improving coordination with clinical providers, to help get patients get the care they need more efficiently.  

“It’s a revamping of the whole system of care,” says Dr. Dennis.  

When the program launched, a comprehensive research evaluation was initiated to assess its impact, patient experiences, and potential areas for improvement. This included a health services monitoring program and a long-term prospective cohort study. Dr. Dennis was invited by Dr. Nolan, the Principal Investigator of the R2R research program, to co-design this evaluation. She applied for the Carraresi Foundation Early Career Clinician Investigator Award to receive funding to support this project.

“This was the kickstart to my career,” says Dr. Dennis. “Being someone new in Vancouver and not knowing many folks in the academic or the Providence Health Care clinical world, it gave me an opportunity to really meet all these different folks and start to collaborate.” 

Her project focused on three main areas: examining how the new model functions and evolves over time; analyzing trends in substance use, quality of life, and healthcare utilization among participants; and capturing patient experiences to understand the program’s impact on their treatment trajectory.  

“The Carraresi Award really helped us come up with a map of what we wanted to look at, in terms of the Road to Recovery system of care and what outcomes we were hoping to evaluate,” says Dr. Dennis.  

The health services monitoring component of the study collects data on patient demographics, types of substance use disorders being treated, and key outcomes, such as how many patients progress to the next stage of treatment. Surveys are conducted to capture the experiences of patients and healthcare providers. 

This evaluation is further strengthened by data collected from the prospective cohort study, which follows individuals who access R2R services over time. The study aims to better characterize the patterns of substance use, clinical profiles, and addiction treatment trajectories of the populations accessing this new system of care. It examines the barriers patients face in progressing through different stages of recovery and treatment, their outcomes after leaving these services, and important predictors and modifiable risk factors that impact a patient’s recovery journey.  

Preliminary results show program improves treatment retention 

Dr. Dennis and her team found that patients enrolled in the R2R program had markedly higher treatment retention rates compared to provincial averages. While 30-day retention rates for opioid use disorder treatment in B.C. typically ranges from 50 to 55%, R2R patients demonstrated retention rates between 70 and 80%.

These results have been presented at major national and international conferences, including the Association for Multidisciplinary Education and Research in Substance Use Care and Addiction’s 48th and 49th Annual Conferences, the College on Problems of Drug Dependence’s 87th Annual Scientific Meeting, and the BCCSU’s 2024 Annual Conference.  

The R2R research program has produced two published manuscripts: one in BMJ Open outlining the study protocol, and another in the B.C. Medical Journal introducing the R2R concept and highlighting the need for a coordinated system of substance use care in the province. Four additional manuscripts are currently under review, exploring topics including the experience and satisfaction levels of patients and healthcare providers within the program, and novel therapeutic approaches that were implemented within the R2R’s acute withdrawal management unit.  

Research will inform program as it expands province-wide 

With recent approval from the Ministry of Health, the next phase for the R2R is to scale up the model across British Columbia, informed by the findings of this evaluation to deliver a new standard of care for addiction treatment. To support this expansion, Dr. Dennis is developing RecoverNet, a cloud-based platform designed to collect, monitor and analyze population-level substance use data, with the goal of creating a single platform that provides a comprehensive view of province-wide patient outcomes. This work has received grant funding from UBC’s Strategic Investment Fund. 

The Carraresi Foundation Early Career Clinician Investigator Award, which enabled this research, was a pivotal milestone for Dr. Dennis. As the first major award she received in her career, it gave her experience in the key aspects of managing a grant: creating a budget, hiring a staff, and running a team.  

“It meant the world in terms of really developing the skills I needed as an early-career investigator,” says Dr. Dennis. “We are in a very interesting time for research, and I think that continued investment in early-career researchers is so important.” 

Providence Research is currently inviting applications for the 2026 Carraresi Foundation Early Career Clinician Investigator Award. To learn more about the award and how to apply, visit our website.  

Providence Research and St. Paul’s Foundation are grateful to the Carraresi Foundation, in memory of Augusto Carraresi, for its interest in supporting early career research at Providence.