A familiar face of addiction

It is tough to make sense of just how deadly the ongoing opiate crisis has been in British Columbia.

More than 1,400 people died from suspected drug overdoses last year.

"I think this is the new normal, where we are seeing close to four deaths a day," says Andy Watson from the BC Coroners Service. "Losing any life is one too many, but losing over 1,400 is certainly troubling."

Numbers released by the BC Coroners Service from 2017 are shocking, sobering, sad, surreal; however, for many, they are still just numbers, this crisis won't affect them. 

It has been roughly two years since a public health emergency was declared and for many, the belief is that it is only the street-entrenched users who are at risk. 

Coroners data reveals that is not necessarily the case. 

Of illicit drug overdose deaths in 2017, 88 per cent happened inside — 59.6 per cent in private residences, 28.2 per cent in other inside locations. 

That is significantly higher than the 11.4 per cent of deaths that happened outside in vehicles, sidewalks, streets, parks, etc.

It is time to change the narrative. 

The majority of people dying from this crisis are using indoors, and it is affecting people from all walks of life.

"It's impacting working professionals, who are family people who have kids at home - people who work in blue collar, white collar work. It is not exclusively a crisis that is taking lives of those who live on the street," says Watson. "It is hitting people who have had long-term histories with using substances, it is hitting first-time drug users and it is hitting people who are using recreationally."

A collaborative group along with the provincial government is trying to get behind the data provided by the BC Coroners Service. 

As part of a new strategy, the province wants to change the narrative. 

The stigma must be lifted, and the conversation has to switch to reflect the data. 

"I still think that the stigma is there because I think that it is difficult for people to have conversations," says Watson. "I think that people who use substances, at least those that have families or maybe have friends that would frown upon knowing that they use substances, there is a level of shame that needs to be removed."

Watson believes those who are using substances in the province need to be able to talk about it, and they need to be able to access resources and need to make sure their drug source is safe. 

Fentynal was by far the top illicit drug detected in overdose deaths over the past two years, followed in order by cocaine, methamphetamines and heroin.  

A former nurse calls substance use disorders 'one of the most pervasive diseases across healthcare.'

"It doesn't matter what area of medicine you work in you are going to see addiction and substance use."

Cheyenne Johnson is the director of clinical activities and development at the British Columbia Centre for Substance Use, a relatively new organization. The BCCSU is supported by the Province as well as various funders in Canada and the United States. 

"Myself, and pretty much everybody I know, has somebody in their life that has dealt with substance use; whether that was a diagnosable addiction that required treatment or somebody that had difficulty controlling their use, or people who use recreationally."

Johnson is working to create clinical care guidelines for healthcare providers, which didn't previously exist in the province. 

The guidelines will provide evidence-based tools and strategies for healthcare workers to understand how to compassionately, and without judgement, talk about substance use with their patients, identify substance use disorder when it is developed and be able to effectively treat it. 

"People that are suffering from addiction or are having issues with substances, look at people in the Downtown Eastside and think 'Well, that's not me; that's not my son; that's not my mother; that's not my aunt; that's not the kid in my class,' when really, addiction touches every person of every socioeconomic background equally. It doesn't discriminate." 

It is hidden in a lot of ways in our society, says Johnson. She gives the example of trades and construction workers. She talks about the pervasiveness of substance use in oil and gas workers who fly in and out of camps. 

"People who are often struggling keep their addiction and substance use under wraps because they are concerned about their jobs, they are concerned about their families and what their loved ones would think."

Johnson says as a society, we need to move to the point where we look at addiction like other diseases. An understanding needs to be met that addiction is a brain disease, and it is chronic and relapsing like other conditions.

"Where people experience periods where they are well and periods where they relapse and need more support. And I really think that having communities and families, employers and others recognize that, that it is no different than another chronic condition and provide the same level of support is going to get us there."

The conversation around the face of addiction and the ongoing opiate crisis is not an easy one, but it is important that we have the conversation. 

Johnson will be speaking at the Okanagan College Kalamalka Campus in Vernon on March 9. The talk is open to the public and is part of the Science in Society Speaker Series.

The talk is titled: Beyond opioids: the overdose crisis — how did we get here?

"In most cases, addiction is not caught early enough, it's not screened for, people don't feel comfortable talking about it, or it isn't even screened by their healthcare provider. There is a lot of upstream screening and support that can be provided where we aren't going to see negative downstream effects of addiction."