Last week, a two-day forum brought together a wide variety of people from the community to look at understanding and responding to a problem that is so big in our province that in April 2016, it was declared a public health emergency in B.C. – illicit drug overdoses and deaths.
The Building a Compassionate Approach: Substance Use, Harm Reduction and the Public Health Emergency community forum took place Sept. 5 and 6 at the Quesnel and District Seniors’ Centre.
At the forum, Dr. Andrew Gray, a Medical Health Officer with Northern Health who is based in Prince George, gave a high-level overview of Substance Use and the Public Health Emergency from a Northern Health Perspective.
He says there has been a “major increase” in illicit drug overdose deaths since 2016, and the introduction of illicit fentanyl into the drug supply has been “the major driver of this epidemic.”
Gray emphasized this is a problem throughout the province, not just in Vancouver’s downtown east side.
“The problem is more often in urban centres, and Prince George is where we’ve seen the largest number of overdoses,” he said, referring to the number of drug overdoses in northern B.C. “Then Quesnel, Fort St. John and Dawson Creek. Really, anywhere we have an emergency room, we’re seeing overdoses.”
He also noted that the overdose rates in the first half of 2018 are just as high in the Northern Interior as they are in Vancouver.
Gray says a history of trauma is the biggest driver contributing to a higher risk of illicit drug overdose, as opioids are used to treat pain, whether physical or emotional.
“We’re in this context where the illicit drug supply has become so dangerous, and people wonder why do people use opioids,” he said. “The No. 1 is because opioids are such a pain inhibitor. When that pain is overwhelming, people will take great risks or go to great lengths to relieve that pain.”
Gray said social drivers include poverty, homelessness, isolation, violence, discrimination and colonization.
“We then also stigmatize and criminalize that opioid use,” he said. “This alienates and isolates people who use drugs and pushes them away from people who can help them, plus it hampers the political will to implement solutions.”
Grays said the criminalization of opioids has also led to a more dangerous drug supply on the black market.
Fundamental solutions are needed, said Gray, and that includes the inclusion and engagement of peer voices, de-stigmatizing, decriminalizing drugs and providing access to safer drugs.
“There’s a lot of fear that if there is more access to opioids, more people will use them, and those fears need to be managed, but at the same time, people are dying because they are using unsafe drugs,” he said.
“As for the underlying drivers of substance use, it’s preventing and healing from trauma, both individually and collectively as a society. It’s multi-generational. It’s going to be a monumental task, but that’s something we need to do every day.”
Gray wants to emphasize that anyone who is interested in naloxone training can visit naloxonetraining.com for more information. Free Take Home Naloxone kits are available in some pharmacies, health units and various places in each community, he added.
Other speakers during the two-day forum included Janine Stevenson, a nurse who has joined the First Nations Health Authority Health Protection Department, speaking about The History of Prohibition; and Len Pierre and Andrea Medley with the Indigenous Wellness Team with the First Nations Health Authority, speaking about Decolonizing Addiction and Indigenous Harm Reduction.
As well, there was a workshop led by members of the provincial overdose Mobile Response Team, reviewing Compassion Fatigue and Vicarious Trauma, Shifting to Vicarious Resilience.
Patrick Smith spoke about Culture Saves Lives, an awareness and direct-action campaign with a mission to reconnect all people with their culture as a harm reduction and life-saving health intervention, especially First Nations people oppressed by mechanisms of colonization.
A Peer and Service Provider Panel shared Lived Experiences in Harm Reduction, highlighting their experiences with harm reduction and how they see it impacting their lives or the lives of people they work with.
Niki Hanson-Seager and Ruth Verkerk provided an overview of the work being done by Moms Stop the Harm, a network of Canadian families whose loved ones have died due to substance use or who hope for recovery, and shared their personal stories of the loss of their children.
Dr. Linda O’Neill, a practising counsellor, certified trauma specialist and counsellor educator at the University of Northern British Columbia, who is the clinical co-ordinator at the Community Counselling Centre in Prince George, spoke about Supporting Children, Youth and Families in Communities of Compassionate Practice.
The forum was organized by local service providers, including Seasons House, peers from the Coalition of Substance Users of the North, Community Health Nursing, the Quesnel Tillicum Society and the Regional Harm Reduction Nurse.
Seasons House executive director Melanie MacDonald felt the event was very successful.
“We’re really, really pleased with how everything turned out,” she commented.
“The diverse workshops and the presenters and facilitators for the workshops were incredible and dynamic. With the exchange of knowledge, we were really pleased because it was a lot of provincial partners who came.”
According to MacDonald, “well over” 100 people came to the forum over the two days.
“It was a really great cross section of people who came out, and there was a lot of relationship building.”
MacDonald said one of the important pieces is trying to address the stigma around drug use and overdoses. Many people have various forms of addictions, whether it is gambling, social media, shopping or sugar, and they don’t carry the same stigma, she noted.
“It’s the illicit substances that carry so much stigma, and right now, with thousands of people dying across our province, we need to address that, because it’s preventing people from getting help and preventing service providers from providing services. I think a big part of this forum was putting the human aspect back into it.”
MacDonald wants to remind people to have those difficult conversations around substance use and to tell people who are struggling that they want to talk and want to help.
“It’s our co-workers and our children and our friends,” she said. “People don’t reach out, and they don’t talk about it, and that leads to people using alone and being ashamed, and it’s the people using alone and in shame who are dying at home.”
MacDonald also wants to encourage more people to get Take Home Naloxone kits.
At the same time as the community forum was taking place in Quesnel, the provincial and federal governments announced funding to address the opioid crisis.
On Sept. 6, Federal Health Minister Ginette Petitpas and Judy Darcy, the minister of mental health and additions in British Columbia, announced a bilateral agreement signed under the Government of Canada’s new Emergency Treatment Fund.
“This agreement recognizes the investment of more than $71.7 million – $33.98 million from the Government of Canada, in addition to the province of British Columbia’s contribution of $37.76 million,” according to a press release. “The funding has been designated to enhance or increase access to quality treatment services for substance use disorder.”