Shanell Twan from AAWEAR Speaking at International Overdose Awareness Day in Edmonton

August 31, 2017

Tansi…Hello and Good afternoon,

I would like to start first and foremost by acknowledging that we are gathering here today on treaty 6 territory on which out of respect for the land and its people must be honored and respected.

For those of you who don’t know me my name is Shanell Twan I am a proud member of AAWEAR [Alberta Addicts Who Educate And Advocate Responsibily] which is one of the co- host Organizations for today’s event.

We are Gathered here today FOR International Overdose Awareness day and to Acknowledge That We fight for those we love and have lost. The harms being caused by the war on drugs can no longer be ignored – so we are calling for more humane drug policies that support, and don’t punish, people who use substances. It is time to leave behind the harmful politics, ideologies and prejudices – and prioritize the health and welfare of those affected. I am here today as a concerned Albertan and an indigenous woman who values the recent truth and reconciliation events that happened across our country. I believe it is time for us to reconcile with the truth and i feel that one of my truths is that as indigenous people we are often overrepresented in a variety of systems: the legal and justice systems, health care, and social service systems.

I find it disheartening that substance use has long been viewed as a criminal and moral issue rather than a health issue. In reality, it is an unpleasant fact that has touched many families. Mine included. I feel it is here that a tectonic shift must take place…treating someone who uses substances must be seen as a bonified health issue.

Because I currently see a disconnect between all systems with class and race often playing a role in how we view substance use or addiction. I feel that people who use substances should be viewed as just that people rather than offenders. Law enforcement and public health should have the same goal of wanting people to do good and stay alive to make a different choice on another day.

We are desperately in need of supervised injection services to help decrease the high number of overdoses we are seeing in communities across our country. When substances are used inside of a health setting and substance use becomes decriminalized people then come into contact with nurses, social and peer support workers that are there to provide them with voluntary drug tapering strategies, education, advocacy, health and social interventions available to them if they so choose. I see a valuable opportunity for us to take a stand on the forefront of this overdose crisis, and provide people using substances with services that will prevent further loss of life due to overdose. Because as it was said in Ottawa at the Canadian drug future forum: ’’the drug supply in Canada has gone toxic’’!

We should all know by now that we cannot arrest our way out of this crisis. We know that mental health factors contribute to substance use and that mental health sufferers are twice as likely to use substances that being said i feel that we need to look around the country and maybe even the world to see what’s working well and look at applying some of those ideas here and now (coughs-like Portugal’s model). Because the death toll rise in spite of current actions and at best a glacial pace is what things seem to be moving forward at. What evidence based things can we look too… where other interventions have failed heroin assisted therapy has had great successes Portugal even greater successes.

At ungass2016- 22 governments from around the world advocated for all drug decriminalization here is a small part of a statement from the idpc- international drug policy consortium-…” the gold standard of decriminalization is the removal of all punishment for drug use and the provision of voluntary health and social services ’’the sad reality is our current drug laws and policies have failed us. I believe herein lies an opportunity for us to show some leadership.

We need to show good models and then scale them up building an evidence base that demonstrates what works safely and effectively to save lives …because the government doesn’t hold all the answers and neither do we. This is why evidence must form the basis of all policies in place. I feel that we are at a crossroads where I think we must acquire the knowledge to build upon societal support to expand upon these services.

I urge you to push pass ideology, prejudice, and fear to step up to help our citizens. Let’s roll up sleeve take bold steps and help people, so no more families have to lose a mother, a father, a son, a daughter, a sister or brother. Or in my family’s case an aunt and two cousins.

We need our governments to make evidence based decisions when it comes to drug policies. We need progressive evidence based policies. We need you to take the ideology out of it and only make evidence based decisions. I do believe we need an integrative knowledge exchange about best practices from across our country, and maybe even the world, we need support from all levels of government to help build upon this knowledge base so we may integrate and facilitate the effective use of this knowledge into practice. To the provincial & federal government i implore you. The evidence is there use it!!

On February 21 2017, a first national day of action was held across Canada by CAPUD to demand concrete actions to put an end to the war on drugs, remove barriers to health care, and implement policies that are informed by real life experiences of people who use drugs and Service providers. At that time, we met Government Officials to share Our thoughts with them and forward our list of CAPUD’s federal demands: in no particular order they are

• End the War on Drugs. In the short-term, decriminalize possession of all drugs. In the long term, full legalization and regulation of drugs.
• Grant immediate exemptions to all supervised injection service (SIS) applicants and/or define them and any future SIS as health services implemented solely by provincial authorities;
• Create a specific harm reduction initiative as part of the new Canadian Drugs and Substances Strategy, to support, expand and adequately fund harm reduction programs and strategies including explicit funding for the development of drug user-based organizations and advocacy groups.
• Remove barriers and increase access to opioid substitution therapy including access to prescription heroin.
• Implement harm reduction in prisons: needle exchange programs, increasing access to opioid substitution therapy and continuation after release

We should be identifying smart policies and implementing them to apply solutions to save lives. I can honestly tell you the vast majority of deaths I am seeing are related to illicit drugs, Fentanyl and Carfentenyl, and now even cocaine and methamphetamine can contain these. I can also honestly tell you that i have attended numerous funerals in the past few months. And i am now at a point where I have to acknowledge my own personal experiences with tackling issues related to my own mental health, because as of lately I feel as though I’ve been plagued by depression. Thoughts and memories of those we’ve lost leave me holding on to hope, hoping those who hold the power can and will do something to help. Now is the time to remember, it is also the time to act!

Hyi hyi ..thank you

Manitoba Moms Meeting with Federal Minister of Health Jane Philpott

Manitoba MSTH leaders Chris Dobbs and Arlene Kolb were invited to attend a meeting with the Federal Minister of Health Jane Philpott in Winnipeg on July 22, 2017.  Here is Chris Dobbs' summary of the event.

With over 30 people in attendance the moms nervously waited their turn to speak to the Minister. Arlene started with a question:  "You want to know what I want? I want my son back! All I have is his hat, and his ashes, I smell his hat everyday to be close to him", as she picks up the hat and smells it.....peoples eyes welled up with tears. She stated clearly that we need to stop the stigma and we need treatment. I then spoke about Adam and who he was, and that he was not his addiction. I talked about our lack of resources and how shameful it is that we have no medical detox or no protocol for our Doctors and emergency health services, no protocol to really help those suffering with the disease of opiate addiction. I went on to read a letter my son wrote, a letter begging me to help him and not give up on him, and that he was scared. Not a dry eye in the house. I questioned whether anyone would put their child in the Main Street project, the only available place to detox. A place filled with both people addicted to alcohol and those addicted to drugs. You bunk up with six others, all sick and one was even a drug dealer. Everyone shook their heads.  I also asked  Max Waddell, from Winnipeg Police Service, as he spoke to picking up persons who are overdosing, what happens to them, what do you do with them? All they can do is take them to ER, check them send them on their way. I asked Minister Geortzen about the recent approval of suboxone and what Doctors are administering it. He admitted that this is a problem, getting Doctors trained to work with suboxone .

Lastly, I related my own experience of 14 years ago, a heart attack. I mentioned that we have protocols and I was treated immediately, given medicines, monitored in hospital for a week, sent to rehabilitation, counselling and follow up every six months which continues to this day! We need protocols to treat people dependant on substances who seeking help. They should not be treated differently than anyone else in the health system. 

Minister Jane Philpott in the centre and next to her, holding photos of their sons, are Arlene Kolb and Chris Dobbs. 

Foundry Kelowna - representatives from multiple services available to help youth

Arlene Howe

Helen and I had a tour of the newly completed Foundry last night!

The initial presentation on arrival in the foyer is an atmosphere that is inviting and calm. Green, turquoise and blue hues have a relaxing effect, plus there is an abundance of light creating an airy atmosphere, not an enclosed, (institutional), feel.

The Foundry will be the home to a dozen different agencies. The key, of course, is to provide early intervention, diagnosis and support before serious, chronic issues arise. There are several physician exam rooms for GP's to assess physical /sexual health of the youth. To date, four General practitioners have committed to part time hours. The facility will also house psychiatrists, counsellors, paediatricians, RN's and various support personnel.

The space is comprised of counselling rooms, dictating stations (for consultations), staff lunch rooms, two conference rooms and a family room.

The Foundry also has an amazing kitchen area for youth-it will also be used to teach cooking classes- promoting healthy independence. Staff will move into their offices and work spaces slowly throughout July, and will see their patients at the Foundry. August will slowly transition to walk In Traffic and referrals. (From schools, physicians, parents, walk ins).

The Foundry mandate that a slow/soft opening will allow them to ensure all protocols are in place and properly executed. They truly want this to be perfectly deployed and a positive experience for all.

Who is the Foundry?

The Foundry is a "one stop" service provider for youth age 12-24. A variety of services will be available to youth, all under one roof.

Family support, youth and family navigation Services, health care, sexual health, mental health counselling, substance misuse counselling, housing support, employment assistance, free courses and groups and specialized services!!!!!!

All services are free and confidential.

Making mental health a priority for our youth not only aids them and their families, but creates strong supportive communities where are children are valued.

I am optimistic and excited to see the Foundry lead the Okanagan, and the Interior-perhaps even the province and the country, in promoting this service for our kids!

I believe they will have a strong voice In educating the general populace and in decreasing, or eliminating, stigma and shame.

The Foundry staff are a strong, youthful, innovative and committed team!

I am excited to watch them develop, morph and grow!

ALL LIVES MATTER

TOGETHER WE WILL MAKE A DIFFERENCE

Hindsight—A Difficult but Valuable Gift - Leslie McBain speaking about losing her only child Jordan

This is the short story of our only child, our son Jordan, his life and his death. It is also about hindsight. Hindsight can be a learning tool—for me and perhaps for you, too.

Jordan was a happy baby, inquisitive and active. As a newborn, he slept only about 10 hours in 24. On the day he was eight months old, he walked for the first time, to the delight of all. He didn’t stop challenging himself physically all his life.

He never required a lot of sleep, which was tiring for mom and dad, but his young life was full of travel, adventure, joy, friendships and family. We felt blessed to have such smooth sailing. The part-time daycare and preschool Jordan attended from age two until public school suited his high energy.

We made an informed decision to keep Jordan in the Montessori kindergarten an extra year as he was so rambunctious. His focus on tasks was not thought by his teachers to be at a Grade One level. But he was happy and sociable. He loved his teachers, and the varied structure suited him.

Jordan continued to be funny and popular and became a leader of his peers. This sounds lovely, but there was also a worrisome side. His antics disrupted the classroom, his reading skills were below average, and he was not a team player. By Grade 5, an older and wise teacher suggested we have him tested for ADHD (attention-deficit/hyperactivity disorder) and dyslexia. He had low levels of both. We employed a tutor, and his teachers gave him the time to run around the school when he needed to release some energy. His report cards were just above average, so while we were concerned, we weren’t overly worried.

Other quirks seemed small at the time—Jordan couldn’t wear socks that had a seam in them, he couldn’t eat an apple that wasn’t quite the right texture, he would sit on the floor of the shower and let the warm water run over him until we intervened or the hot water ran out. There were smells that he couldn’t tolerate. He had episodes of rapid blinking that he couldn’t control. He had occasional brief rages at home that consisted of yelling in intense frustration over a seemingly insignificant thing. Again, while we were concerned, we didn’t think professional help was needed.

And then, high school! We all know the pitfalls and perils of these years. Kids from our small southern Gulf Island in BC take a water taxi to attend the Gulf Islands Secondary School on one of the larger islands. This meant that I could not be as involved with the school, and sometimes Jordan had to stay overnight with another family. Up until this point, Jordan, his dad Carl and I had been close and happy. But now we began to see changes. Jordan started to party with his friends—typical except for the copious amounts of pot and alcohol that he and his friends consumed. He was open about this with us, and occasionally took us up on our offer of the no-questions-asked ride home.

But you can’t keep a teenager locked up because you think he might get drunk or smoke pot. You can’t follow him around or text him every 15 minutes to find out what he is up to. I did what I could: I talked to him about how pot affects the developing brain, and about the dangers of alcohol addiction. I printed out articles and left them on his bed. We watched him closely, and we hoped that this was just a stage he was going through.

But it was not. By age 19, Jordan was an alcoholic and a cigarette smoker. He was also using cocaine. He soon asked us for help; we got him into a rehab facility for what was to be a three-month stay. He walked out after six weeks, declaring that six weeks was all he needed, that he was clean and sober and could stay that way.

He was wrong, as many of us are at the age when we think we know everything.

The next three years were torture for my husband and me. Jordan bounced around from our community to Vancouver to the Cayman Islands, to Ottawa, to Mexico and home again. He was on an adventure laced with drugs and alcohol. He was dealing drugs. He loved the fast lifestyle, the cool clothes and being the life of the party. Miraculously, he was never arrested.

Throughout this period, we know, from anecdotes told by his friends after his death and from what we already knew about our son, that Jordan remained kind and connected. He championed the underdog, he helped those less fortunate than himself, and he loved children and animals. And he stayed connected to us, by phoning, texting, even bursting through the back door unexpectedly. But we saw the effects of drugs and alcohol—in his eyes, in his thin body, in the lies he told us about money or his whereabouts. He was constantly texting, and we now know that he was “conducting business”—dealing drugs.

Jordan returned to our small community in his twenty-second year with a steady girlfriend, and he started his own small business. We were hopeful, although we knew substance abuse was still a problem. Then Jordan injured his back on a job, and our family doctor prescribed the highly addictive opioid oxycodone. A few weeks had passed before Jordan told me that the doctor had prescribed him a hundred pills. I was shocked; I made an appointment with the doctor and told him that Jordan was at risk of addiction. But because Jordan was over the age of consent, and because the doctor seemed not to consider my advice, I had no say in Jordan’s care. This was the beginning of the end—and the first failure of the medical system in Jordan’s case.

Over the next six months, the doctor prescribed oxycodone in higher and higher doses. Jordan became completely focused on obtaining and using this drug. We watched helplessly as his business declined, his girlfriend struggled, and he developed other health and sleep problems.

I spoke to the doctor again and told him that Jordan was now addicted to the drug. The doctor became angry and defensive. He decided to stop prescribing the drug, but he did not offer any support for withdrawal and recovery from addiction. Looking back, I believe he was simply ignorant in the matter. One cannot just “quit.” Withdrawal is so painful that some find it impossible to go through. The physician’s ignorance and oversight was the second failure of the medical system.

At this point, now firmly addicted to opioids, Jordan began buying “Oxy” on the street. He needed more and more money, and slid right back into the world of drug dealing.

Finally he realized that life had become untenable. He knew he needed to enter a detox facility, and we helped him get there. After 12 days, he emerged clean of opioids but still faced a very painful withdrawal. We could find no post-detox support, no physician willing to prescribe suboxone (a drug that Jordan had researched and which is now widely and successfully used in withdrawal and recovery), and no psychiatrist who could take on Jordan’s case. This lack of post-detox support was system failure number three.

Seven weeks after he left the detox facility, and in a bad state of withdrawal, Jordan relapsed. On February 4, 2014, at the age of 25, our only child died alone of an accidental overdose.

In hindsight, we can now see that all the little things—the high energy, the quirkiness, the sensitivities, the risk-taking, the problems with focus and dyslexia, Jordan’s overcompensation for hidden anxiety—led our son to self-medicate. But we couldn’t put it all together at the time. And now he is gone.

As I now advocate for drug policy changes in government, I understand that the medical system was not ready for the recent sudden increase in addiction and overdose. Doctors have historically received almost no training in addictions and recovery, and that is now changing. Opioid prescription and management is becoming an integral part of medical school.

Advice is a hard thing to hand out: every child is different. I can only say to other parents, Be aware, be non-judgemental, and give your children credit for being intelligent. Try to leave anger out of discussions. Your children need your wisdom, not your fear. And they need your love. They really need your love. They also need information on how to avoid dangerous drugs, and they need to know that if they do decide to use drugs and alcohol, they should never use them when they are on their own. Make sure your child’s school is including talks on drug safety in the curriculum.

Hindsight may be 20/20, but it can be a hard thing to live with. I hope that our hindsight can be your foresight.

Leslie McBain, May 2017

Hindsight—A Difficult but Valuable Gift

From "Families and Crisis" issue of Visions Journal, 2017, 12 (4), p. 12

Helen Jennen's presentation to the Canadian Association of Emergency Physicians

If I use the word, addict, many minds will conjure up images of a filthy toothless, dead eyed, man or women hiding in a back alley with a needle in their arm or begging for a few dollars on a street corner.I tell my story as a mother with lived experience to alter that image, to share the human side of drug misuse. To encourage you to believe although they have made a few bad choices, they do not choose this way of life. No one aspires to the living hell of addiction.

I have lost two sons to overdose. I cannot even begin to tell you about living life without your children, long nights laying awake, wishing apon wish to see them, hear them, hug them. The day after day reality that this will never happen.

My boys stories are quite different. Rian after 8 years of abstinence was hit by a truck while driving his motorcycle. He sustained horrific injuries to his leg. For three years, many surgeries,and countless prescription drugs, he battled chronic pain, depression and anxiety.

On August 21,2011, Rian died alone in his bed of respiratory failure due to an overdose of narcotics and benzodiazepines. I found him the following morning.

Tyler’s story is more relevant to the current opioid epidemic. Ty was living a charmed life. He was smart, witty, industrious, athletic, extremely funny and totally fearless. He had startling good looks and things came easily to him. He was a true adventurer. He climbed and went scuba diving in the most amazing mountains and waters in the world. He loved to travel and eventually settled in Thailand where he quickly picked up the language and soon had built himself a successful business and a happy life. Here he fathered his first child, Mac.

Tyler was caring and kind with a big soft generous heart . He was hailed a hero in the Canadian press for saving a drowning Thai boatman in the devastating Tsunami that hit the coast of Thailand on Boxing Day in 2004. That was not the first or the last time with no regard for his own safety, he saved another’s life.

After the Tsunami, with may friends lost and his business destroyed, Tyler brought his family home to Canada. We have no idea what impact that Tsunami had on Tyler’s mental state, but thought he was exhibiting signs of post traumatic stress. Starting over again was not easy, but Ty adapted quickly and in no time had his own masonry business.

In 2010, Tyler ruptured his a chillies playing football.. He underwent surgery and was sent home with a prescription of Oxycontin. With all the other components most likely in place, he developed a dependency on opioids. Tyler did not cope well with Rian’s death. Shortly after, his drug abuse escalated to heroin, it was far cheaper and much easier to obtain than oxycontin.

As a family we were launched into the search for help. We spoke to physicians, psychiatrists, outreach workers, treatment centres, RCMP and even to members of the clergy. Along with drug misuse, mental health issues develop. Personally, I believe addiction and mental health issues are dance partners, who leads depends on the day and the circumstances. With large gaping holes in the system, there were no clear answers, no concurrent care,so our lives became riddled with trauma and fear.

Totally unqualified, the spare bedroom in our home now became an emergency room, a detox, a rehab, a homeless shelter, a jail cell and on the worst of days, a war zone. Countless nights I sat on the sofa with my son’s head in my lap and we both cried for the man he had once been, the one we longed to bring back. Supporting his addiction, Tyler broke his own moral code and his shame and self loathing only added to the relentless drive to use.

Although treatment centres were virtually impossible to access, Tyler tried a number of ways to become drug free. In December of 2016 he joined a 12 step program. On January 13, Ty returned from a recovery meeting. He was in high spirits, even optimistic. He came around my bed and taking me in a big bear hug, he told me how much he loved me and how he could not live without me in his life, he then did the same with my husband.

The next day we left for work, for the first time in ages he was sleeping peacefully and we did not wake him. At work that morning I received an e-mail from an old friend of Rian’s. I had not spoken to Betty in well over a year, but she wrote, I am not sure what compels me to write to you today, I needed to let you know I feel Rian’s spirit so strongly and feel he is right there beside you.

As I left work that day, a fire engine with sirens blaring roared around me into on-coming traffic and flew up Pandosy Street. I ended up following that truck and when it stopped in front of Tyler’s ex-wife’s apartment, my heart plummeted.

I was forced to remain in the hallway outside the apartment as first responders worked feverishly to re-start my son’s heart. Finally they let me in and for the second time I layed down with my dead boy and whispered things in his ear I knew he could no longer hear.

I will never know what triggered Tyler to use that day, he died from a pure fentanyl disguised as heroin overdose. I try to convince myself that Rian did come to guide his brother to a safer happier place.

In a text to me a few weeks before he died, Ty wrote, Mom I just need you to know. It took me weeks to figure out it”s meaning and will haunt me until I die. What he wanted me to know was that he loved us all more than enough, but alone without the appropriate help, he knew he could not win this battle. Our constant messaging, well if you only wanted to stop, if you would just try, were so damn far off the mark. The standard advice of, he needs to hit rock bottom, or you need to practice tough love….I now see as utterly ridiculous. If we do not see the total destruction of ones life, the loss of family and friends, the inability to hold a job or support oneself, the never ending quest to stick a needle in your arm two or three times a day, just to escape your sad reality for a few hours is not rock bottom, we are blind. and as far as tough love,well the toughest love you will ever see is that of a mother trying to save her addicted child.

In February of 2016, I became a member of Moms Stop The Harm MSTH is a network of Canadian mothers and families whose loved ones have died from substance misuse. Our network calls for an end to the failed war on drugs. We envision a new approach based on reducing harm, where people who use drugs are treated with respect, compassion and support.

I am often asked, how do you do it, keep going, keep advocating. I do it for Rian and I do it for Tyler. I do it for Tyler’s children, for surely with their short history they are at high risk for mental heath and drug misuse. I do it to reduce the shame and stigma that surround addiction. To bring awareness and perhaps prevention. To help society recognize that these are medical issues, not moral failings. To have you all see it can happen in the best of families to the nicest people.

I can only imagine what you as emergency physicians are faced with on a daily basis. Hopefully my message will stay with you and remind you, they are not here by choice and that they have a Mother waiting fearfully for you to do what she has not been able to, for you to save her child. Whatever you are to learn here today, I implore you to implement it quickly. As you know, recent statistics show that in 2017 we are on track to lose 1300 people in our province to overdose.

Let’s abolish the stigmatizing word, addict. Let’s see them all as suffering human beings and let’s try without judgement to help them.

Helen Jennens,

Whistler, BC, June 3, 2017