Martin Schechter

Martin T. Schechter (born December 16, 1951) is a Canadian epidemiologist recognized for contributions to research about HIV prevention and treatments, addiction research, and Indigenous health research. He is a professor and was the founding director of the School of Population and Public Health in the Faculty of Medicine at the University of British Columbia (UBC). Schechter received his Order of British Columbia in 1994 alongside BC's first Nobel Prize laureate Michael Smith and noted Indigenous artist Bill Reid. In 2022, Schechter was named as a Member of the Order of Canada.

Education Schechter completed his Bachelor of Arts in mathematics at York University (1973), his Master of Arts in mathematics at UBC (1975), his Doctor of Philosophy in mathematics at the Polytechnic Institute of New York under the supervision of Wilhelm Magnus (1977), his MD in Medicine at McMaster University (1981) and his Master of Science in epidemiology at the University of Toronto (1983).

Contributions to health research Schechter combines interests in clinical epidemiology and health services research with HIV/AIDS and urban health research including opioid addiction research. He is also active in Indigenous health research. Schechter is the author of more than 400 peer-reviewed publications and 600 abstracts and scholarly presentations. Airing public service announcements about condoms in movie theatres caused a public and private debate between Schechter and then-Premier of British Columbia Bill Vander Zalm. Had HIV not been such an emerging health crisis, Schechter likely would have continued in the field of breast cancer. Providing injections of medically prescribed heroin in a clinic setting was projected to save about $40,000 per person in lifetime societal costs compared to methadone.

Schechter was also involved as a lead investigator in the follow-up to NAOMI, the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) funded by Canadian Institutes of Health Research. The SALOME trial established that the licensed analgesic drug, hydromorphone, was as effective as heroin in the treatment of severe opioid dependence, opening another avenue for treatment with injectable medications. In 2013, then Federal Health Minister Rona Ambrose controversially cancelled an approval from Health Canada regarding compassionate use of heroin for some research subjects after they completed the trial. Schechter questioned the value placed on research evidence by the federal government of the day. The BMJ requested and published his commentary Drug users should be able to get heroin from the health system in April 2015.

Following a change in the Canadian federal government in 2015, substantive changes were made to Canadian policy regarding the use of diacetylmorphine and hydromorphone, particularly in response to the opioid overdose epidemic. In 2018, the Canadian government amended regulations to make medically prescribed heroin more accessible. Specifically, the new rules allow for administering diacetylmorphine outside of a hospital setting, and let nurse practitioners administer the drug. In 2019, Canada became the first country in the world to approve the use of hydromorphone for severe opioid use disorder based on the results of the SALOME trial.

Indigenous health research

Along with Patricia Spittal and Kukpi Wayne Christian (Splatsin Secwepemc Nation), Schechter has served as principal investigator of the Cedar Project, funded by the Canadian Institutes of Health Research. The Cedar Project began in 2003 and involves 800 Indigenous participants between the ages of 14 and 30 who use non-injection and injection drugs. All aspects the study are led by the Cedar Project Partnership, an independent coalition of Indigenous Elders, leaders, and health/wellness experts. Cedar studies have highlighted the ongoing impacts of settler colonialism on Indigenous families and communities, including the foster care system, sexual abuse, extreme poverty, and racism. Cedar research has provided critical quantitative and qualitative evidence of these intergenerational colonial harms among young, street-involved Indigenous people who cope by using criminalized drugs.

Along with Nadine Caron, Schechter helped to co-found the UBC Centre for Excellence in Indigenous Health in 2014, and they serve as its inaugural co-directors. The centre is a single coordinating point for Indigenous health initiatives within UBC and acts as a contact for communities and organizations external to UBC. The centre is dedicated to advancing Indigenous people's health through education, innovative thinking, research, and traditional practice. It works to improve wellness, health care and patient outcomes, and promote self-determination that includes increasing Indigenous leadership in all aspects of health and health care.

Recognition

One of only two Canadians awarded the National Health Scientist Award in AIDS by Health and Welfare Canada (1986). Member of the Order of British Columbia (1994) Tier I Canada Research Chair in HIV/AIDS and Urban Population Health (2001) Science Council of British Columbia Gold Medal (2002) Fellow of the Royal Society of Canada (2004) Fellow of the Canadian Academy of Health Sciences (2005) Member of the Order of Canada (2022)