Street Degree in Overdose Prevention reaps benefit of SFU’s Social Innovation Certificate

By Kim Mah

As a clinical nurse educator, Sally Kupp will never know how many lives she’s saved. But now that she has co-created the Street Degree in Overdose Prevention program, it’s safe to say this new graduate of the Social Innovation Certificate program at SFU Continuing Studies is having a significant impact on the overdose crisis in Vancouver’s Downtown Eastside.

Working as a clinical educator on the Overdose Emergency Response Team at Vancouver Coastal Health, Kupp teamed with the non-profit Portland Hotel Society (PHS) to found the Street Degree in 2017. The program has since trained some 350 peers—current and former drug users—who work at local overdose-prevention and harm-reduction sites.

“I have one peer who said they’ve helped reverse a couple hundred overdoses themselves, and they’ve trained many people as trainers in overdose response with Naloxone, a drug used to block the effects of opioid drugs,” she says. “So, there’s this ripple effect.”

Kupp was inspired to create the Street Degree while developing a comprehensive orientation program for professionally trained staff at a supervised drug-consumption site. She discovered, however, that the peers, who do this same life-saving work with drug users, are largely untrained yet support at least 75 per cent of all people at risk of overdose in Vancouver.

While the lived experience of peers is invaluable, they lack formal training in many areas, including managing extreme situations or working with special populations. So Kupp developed 22 courses to address these identified knowledge gaps. Peers who complete 10 courses earn a Street Degree to acknowledge their achievement and to help them secure future employment.

“Most of these people never finished high school, and maybe once had 15 or 20 minutes of Naloxone training,” says Kupp. “For them, sitting through these two-hour classes and then graduating after 10 courses is a big deal.”

When she started the Street Degree, Kupp recalls “going rogue,” basically running the program off the side of her desk. But as the program grew, she realized she needed support. A year into the project, she signed up for SFU Continuing Studies’ Social Innovation program.

“I didn’t realize that what I was already doing was social innovation,” she says. “But I figured if I was already doing that, and there’d been many people years before doing this process and learning from it—then what could I learn from them to improve my work?”

Kupp appreciated the chance to work with an executive coach as part of her learning.

“I was challenged every time we met to push outside my comfort zone, to ask bigger questions,” she recalls.

She also learned a valuable lesson about scaling operations: “I had this idea that going up and out and bigger was better, but in actuality, I needed to look at scaling deep and changing the culture—changing the rules to support what we’re doing, rather than focus on serving more people.”

One significant cultural shift that Kupp witnessed was with the Street Degree participants from the Tenant Overdose Response Organizers (TORO) program. TORO volunteers are residents of single-room occupancy buildings who help fellow residents with harm reduction.

The TORO participants gained confidence in their abilities as they moved through the courses and felt their own knowledge and experience being validated. As they saw their colleagues join in the lessons, some even earning their Street Degree, a new learning culture began to emerge at TORO.

“The TOROs are so grateful for education and they’re extremely smart,” says Kupp. “Part of the program is really a reinforcement of that knowledge that people already have. I’m constantly humbled by what the peers actually know, and what they continue to teach me”.

“I feel so privileged to work with these people. It’s the best part of my job.”