Alberta Votes: #MSTH and #CTF release report card on political leaders’ overdose epidemic response strategies

Addressing the Overdose Epidemic in Alberta: Most party leaders underachieve

April 3, 2019: When the next provincial government takes office, it must take immediate and decisive action to address the overdose epidemic claiming two Albertans’ lives every day.  While this pace of preventable death seems to some like a new normal, each loss rocks families, friends and communities and takes an unforgiving toll on Alberta’s economy. Addressing this unprecedented public health emergency must be a priority for our next Premier.

Two Alberta-based community groups – Change the Face of Addiction and Moms Stop The Harm – invited all provincial party leaders to complete a brief online questionnaire. The questionnaire contained four questions about leaders’ proposals across what are described as the “four pillars” of substance use policy: prevention, treatment, enforcement, and harm reduction. We also assessed the extent to which leaders have demonstrated a personal commitment to protecting all Albertans affected.

As of April 2, 2019, only David Khan of the Alberta Liberal Party responded directly. We therefore collected the remaining leaders’ available policy documents, public announcements and commentary. With the assistance of provincial content area experts acting as concerned citizens, we graded each leader’s approach.    

This exercise leaves us deeply concerned. Most leaders do not describe action that is proportional to the magnitude and urgency of this crisis, and some leaders endorse policy directions that are more likely to harm than help. For example, increasing drug investigation and enforcement may be politically appealing, but evidence shows these measures increase stigma, exacerbate social inequities and discrimination, and increase harms of substance use. In the meantime, the threat of punishment does little if anything to prevent substance use, and it increases violence in the drug trade.

Some leaders propose addiction treatments that research has proven relatively ineffective for opioid addiction. For example, mandatory detox services, abstinence-based residential programs, and “faith-based” treatment approaches do not achieve optimal health results. In some cases, candidates endorsed interventions that could increase the risk of overdose death. Besides being ineffective, some of the suggested treatments could not be scaled to the extent required to meet population demand. While more money for treatment is desperately needed, we need to invest in treatments that are shown to work. At least equally concerning is some leaders’ view that life-saving harm reduction services that have finally been established in Alberta should meet additional bureaucratic requirements that would at least delay their expansion if not cause their closure. Having reviewed party leaders’ positions, we fear – as do public health experts nationwide – that the progress made towards evidence-based services like supervised consumption could be undone following this month’s election.

Albertans should expect that in a public health emergency, our leaders will perform at an A-plus level, acting rapidly, resolutely, and consistently with the best available evidence to protect human life. This issue requires critical attention in the lead up to the election, and it appears our Premier-hopefuls have some schooling to do before April 16th.

Background:  Change the Face of Addiction and Moms Stop The Harm are two Alberta-based community groups made up of citizens who became advocates after they witnessed the lack of supports and services for family members experiencing addiction. Many members of these organizations have had loved ones die from overdose.

In Memoriam Jordan McBain Miller August 28, 1988 - February 4, 2014

February 4th will mark five years since my son Jordan passed away from an overdose of prescription drugs. I miss him as much today as I have done on any day over these years.

Jordan was a person who cared deeply about family, friends, and animals. He did not have time to really develop a philosophy about his life in the world. Youth and addiction can do that to a person.  While he knew deep love, he missed out on marriage, children (he loved kids!), growing wisdom and the joy we experience in the world of the living.

He is remembered with love by his friends and his family. We knew him as funny, over-the-top, risk taking, caring, skilled, and smart.  But as a person involved in drugs, he was often anxious, scared, rude, irresponsible. Addiction does that to a person. It did not come from within the beautiful soul of Jordan.

You may be surprised that I include Jordan’s addiction in this piece as it was only a small part of who he was. But that is what took him away. My life’s work now is to support the lives of people who use drugs, families with a loved one using drugs, and to advocate for more compassionate, evidence-based drug policies. No one should lose a child.

Senseless, accidental and preventable drug deaths must end. The stigma around drug addiction must end. No one should suffer needlessly from drug harms. Jordan brought love and joy to my world for 25 years, and for that I will be forever grateful.  In Jordan’s memory I ask that everyone educate themselves on the nature of addiction and the treatments for it.

Leslie McBain

Movie Review - A Beautiful Boy

I watched beautiful boy 2 nights ago. It seemed disjointed and somewhat superficial and impersonal.
It’s as though this family was swept into a terrifying journey through their son’s addiction and then the storm ended and that was it. It’s an experiential story that seems to lack the reflections and insights I was craving as the mother of a person who suffered from addiction. There is no moral to this story, no lessons or pearls of knowledge, nothing to educate us.

In fact, the message of this story seems to convey that everyone but the person with addiction is a victim with no choices, and only a person suffering from addiction can help themselves. Worse, it seems to suggest that being addicted to substances were a choice. Neuroscience tells us otherwise. With great actors and a timely and socially relevant theme, I think the implied promise of this film is misleading/disappointing and I give it 2 thumbs down.

Tamara Scullion, MSTH Leader for Quebec

MSTH at Stimulus Conference Edmonton, AB October 2018

An open letter to the mayor of medicine Hat Alberta in support of SCS

I grew up in Medicine Hat and consider it my hometown, although I now live and work in BC as a school psychologist. The topic at hand is an issue that no one is immune to – addiction and mental health. More specifically, I am writing in support of the proposed Supervised Consumption Site (SCS) in Medicine Hat based on first-hand lived experience as a sister and daughter of loved ones whose lives were lost to this epidemic, and as a professional who is informed about the science and evidence in support of these sites. I am also an ally of the group Moms Stop the Harm (MSTH), which is a network of Canadian families whose loved ones have died due to substance use or who hope for recovery. MSTH calls for an end to the failed war on drugs, which is a war on the people we love. We envision a new approach based on reducing harm, where people who use drugs are treated with respect, compassion and support.

First, I’d like to say that the landscape and consequences of drug use have changed drastically over the decades with the rise of opiates and methamphetamine use. Speaking as a sister, I have been completely devastated by the suffering that I watched my brother endure that eventually ended in his early death at the age of 36. He spent nearly 25 years in active, severe addiction beginning as a pre-teen, fuelled by complex trauma, untreated mental health and neurodevelopmental challenges, and access to prescription opiates in the household as a teen. Those who knew him would remember his generous, soft-spoken nature, and the love he had for his little dog and for me, his sister. I can’t imagine loving anyone more than I love him. Though there were signs that his drug use had become extremely problematic, I never once entertained the idea that he was injecting drugs…because I believed it was “those people” – the dirty, disgusting ones living under a bridge who would resort to that sort of awful behaviour. Did I ever wake up when I found out that my handsome younger brother had been injecting for almost 10 years, and had by that time destroyed nearly all of the veins in his body through his drug use. He had also suffered a serious case of flesh eating disease that almost resulted in an amputation of his arm that he did not tell me about out of shame that I would find out about the extent of his disorder. I saw my brother deteriorate from a physically healthy young man to a person completely overcome by the devastating physical and mental effects of his addiction from which he saw no possible way out. No one in their right mind would continue self-harming behaviour with such devastating consequences if they were able to simply make a choice to stop. Addiction is a complex brain disorder that affects cognition, behaviour, and impulse control.

It is for him, and for all our affected sons, daughters, mothers, fathers, friends and partners that I write to advocate for the supervised consumption site in Medicine Hat. While I understand and appreciate the concern of the general public about this site, I implore each and every person to consider all of the evidence, statistics and probabilities involved in this particular issue in order to take an informed stance.

If my brother had access to the supervised consumption facility, I believe he would still be alive today. The reasons for this, based on his lived experience, are as follows.  1) Promotion of safe injection behaviours, meaning primarily, for my brother, that his veins would not have been destroyed. He would have been instructed on the proper methods, using the proper equipment and techniques to minimize the physical damage to his veins and skin. He avoided seeking medical help and treatment in general due to the intense shame he felt as multiple people tried repeatedly using fancy lights and techniques to locate veins in his body, all the while turning white and almost vomiting due to the intense anxiety and shame he felt. When a medical emergency arose that threatened his life, which happened multiple times due to the significant health complications associated with his drug use, doctors would have been able to draw blood and administer IV fluids and drugs quicker, an issue that was related to the cause of his death. 2) Increased positive interactions with medical/clinical personnel, meaning that he might not have had such intense fear and aversion to interactions with health care professionals. If he was more willing to engage with the health care system, he would have been much more likely to engage with supports to treat his disorder. 3) Increased likelihood of engaging him in treatment. I encouraged my brother at length in many ways to engage in various treatment options. The only interest he expressed was in connecting with a peer mentor he met in the community who had showed him personal interest and care. This peer did not provoke shame in him because he was kind, compassionate, and had experienced recovery. This peer made him feel like he mattered and that he was cared for. Each and every interaction with staff at the SCS is a relationship building exercise in which the client is treated with respect and dignity, which is often not the case for these individuals in the rest of society at large. It is through that relationship that trust is built, self-worth is discovered, and the chances of engaging in further treatment options is greatly enhanced.

Speaking as a professional who values science and research-based evidence, a recent meta-analysis of 75 studies found that at the population level statistically, supervised consumptions sites 1) enhance access to primary health care and social services, 2) greatly reduce overdose and death, 3) do not increase drug injecting, drug trafficking or crime in the surrounding environments, and 4) reduce public drug injections and dropped syringes (Potier et al., 2014). In Alberta, SCS’s have helped people who use drugs close to 85,000 times. Each of those visits represents a care episode where someone like my brother was treated with compassion and offered an opportunity to move towards positive change. The Alberta sites have saved lives by reversing 1070 overdoses, and the Edmonton site alone has received 5372 referrals to other health and social supports. (The availability of those supports is another issue that we as a society need to collectively tackle!).

Let’s provide our loved ones with dignity rather than shame, and with hope rather than despair. While I understand fears such as increased risks to the neighbourhood or decreases in sales, we are talking about our loved ones’ lives, and their deaths. They deserve access to evidence-based treatment and respect as much as your families and businesses do. Let’s come together in our common humanity and find ways to mitigate the risks that some community members are concerned about, while also providing respect, compassion and evidence-based treatment for those suffering wit substance use disorder. Each of those affected is somebody’s someone.

Dana Dee on behalf of my late brother.