Sheila Jennings, MSTH Ontario Leader
On April 5, 2018 the British Columbia government issued a press release stating that it will allow nurse practitioners to prescribe hydromorphone, methadone and suboxone. This progressive public health measure was put forward to save lives in the present opioid drug crisis. This measure is progressive because many Canadians still view those who’ve overdosed or who are at risk of doing so, with a mixture of fear and contempt. For others however, these are our children and the fathers and mothers of our grandchildren. As such, to us they matter.
The backdrop to the BC health policy initiative is the shocking number overdoses, many of which involved exposure to the drug fentanyl. There were 982 deaths in BC in 2016, with 67 % involving fentanyl. Approximately 1,422 overdoses occurred in B.C. in 2017 and fentanyl was implicated in 80% of those deaths. In Alberta almost 1.9 people a day died from fentanyl poisoning in 2017. That number is growing. Several people overdosed in Saskatchewan last month. Fentanyl had arrived on the scene.
An Ontario MHLTC News Release reported that from July to September 2017, there were 2,449 ER visits for overdose, up from 1,896 in the previous three months. Deaths due to overdoses rose dramatically from 2016 to 2017. Those ambulances you see go whizzing by on their way to an emergency room, people’s children are dying inside them. My child was in one of those ambulances. The Canada Health Agency recently reported that there were over 4,000 overdoses in Canada last year ̶ 1,500 more than in 2016. Advocate Zoe Dodds has referred the crisis as ‘carnage’. Advocate, Vikki Reynolds, referred to it during a workshop I attended as a ‘horror show’. The collective noun for a group of crows is ‘a murder’. I’m going with ‘a massacre’ of overdoses. In 2015 my son’s heart stopped during an overdose. A not uncommon event in these kinds of overdoses. These numbers make it feel like a massacre to me. Fortunately for us, a woman nearby saw and had called 911. She remained with my child and she remains, whoever she is, in my mind.
Mothers want more progressive health care initiatives. In 2017 Ian Hanomansing published “If it hasn't happened ... it's coming': Mothers of addicts urge a radical approach to fentanyl crisis.” The article features women speaking about their children’s experiences with drug use. They told their stories in the setting of extreme stigma to illustrate the need for change in our orientation towards those who use drugs. Their message: stop criminalizing drug users and start protecting them instead. They warn people will not stop dying until Canada wakes up.
We must learn from those with lived experience, and in particular from youth who’ve survived. They are the experts. We can also learn however from mothers living the crisis. As well, professionals with various forms of real life experience with the crisis, like Leigh Chapman and Zoe Dodd in Toronto, and Vikki Reynolds in BC are working very hard, caring, educating and advocating for others about the opioid crisis that affects all of us. I’m fortunate that Chapman provided us with extremely helpful personal advice by phone. We must listen closely to what these experts say, because too many people are discovering a very hard way that there’s little margin for error. Death can come to your family in an innocuous looking pill. Don’t underestimate the power of peer pressure, if you do not want to learn that your child has died, or is fighting for their life in an ICU, learn from those who have.
You can also learn about the crushing effects of stigma. Jettison terms like drug addict and junkie from your vocabulary. Learn about opioid dependence and withdrawal. Find out about ‘harm reduction.’ According to a recent Angus Reid poll, 1 in 8 Canadians (12.5%) know someone who became opioid dependent in the last five years. Yet Statistics Canada’s January 2018 Opioid Awareness Survey found that only about one in fifteen Canadians (7%) know how to access Naloxone and use it to interrupt an overdose until help arrives. Get a Naloxone Kit and ask someone how to use it. Do this, because if you come across someone who has overdosed ̶ and some of you reading this will ̶ they will be relying on you for help.
Support safe injection sites. Or at least don’t oppose them. The opioid crisis is the menacing force to be reckoned with; drug users are not. One mother in the article I mention above comments of the overdose crisis, “If it hasn't happened in your family ... either you're in denial or it's coming.”
It’s a fact. Be prepared.