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7Feb

Record overdose deaths in 2018 prompt calls for safer supply

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Despite increased work to combat B.C.’s public-health emergency, more people died of an overdose in 2018 than any other year on record, leading to calls to make heroin and alternatives available at the doctor’s office.

The B.C. Coroners Service said Thursday that 1,489 people died of a suspected illicit-drug overdose in B.C. last year, up from 1,487 in 2017. Most who died were men (80 per cent) aged 30-59 (71 per cent), and most died indoors (86 per cent). Fentanyl, an opioid being cut into heroin and other drugs, was detected in about 85 per cent of the deaths, up from 82 per cent in 2017.

Made with Flourish

People running overdose prevention sites and expanding access to Suboxone treatment and the overdose-reversing drug naloxone have been credited with keeping the crisis from getting worse.

But to actually reduce the death toll in 2019, provincial health officer Dr. Bonnie Henry said B.C. needs to introduce a safer supply of drugs to replace the toxic street-drug supply.

Henry said it’s important to first have low-barrier access to opioid-agnoist treatments like Suboxone and methadone for people on a path to recovery. But for some people, swapping out their fentanyl-poisoned street drugs with pharmaceutical ones needs to be a first step.

“For people who, right now, have an addiction to opioids … and are relying on this contaminated street-drug supply on a daily basis, and they’re not in a place in their lives where they’re willing or able to enter the treatment side of the spectrum, we need to have options to provide them with a safer supply than what they’re getting on the street so that they stay alive during this period of time,” she said.

“They’re at such high risk of death right now.”

Made with Flourish

Dr. Jane Buxton of the B.C. Centre for Disease Control said people should be able to seek access to a regulated, safer supply of opioids through a physician.

“Depending on who it is, we still know that going through treatment, that suits some people,” she said. “Other people, especially (those) on Suboxone, that can be life-changing. But that doesn’t suit everybody, so we have to have that variety of options.”

She pointed to a program run by the Portland Hotel Society’s Dr. Christy Sutherland, who has started 300 people on liquid hydromorphone and who last month added 50 more spots for people to crush hydromorphone pills and inject them.

When certain people who use drugs are engaged with the health system in this way, they can go on to seek treatment, food, housing and other supports, Buxton said.

“What we’ve seen in the past is that when people have a stable supply, then their life becomes more stable, then they’re able to potentially think about other treatment and being on other opioid-agnoist therapies,” she said.

“Most people are seeking drugs in the illicit market, which are dangerous, and it’s hard to be stable when that’s part of your life and things are so toxic.”

Jordan Westfall, president of the Canadian Association of People Who Use Drugs, said he found hope in the chief health officer’s comments about a safer supply.

“I think the barriers need to be reduced,” Westfall said.

He said programs like the Crosstown Clinic, which provides medical-grade heroin and hydromorphone, are crucial, but for some people the requirement that they visit clinics or nurses several times a day is too high a barrier.


Jordan Westfall, president of the Canadian Association of People Who Use Drugs, outside Insite in Vancouver on May 17, 2018.

Gerry Kahrmann /

PNG

Westfall added that not all people who use drugs seek recovery, and some will continue to seek street drugs to treat their own pain or feel the euphoric effects.

“We need to make sure our programs are as accessible as the street-drug supply which, for many people, is very accessible,” he said.

“You should be able to go to a physician and get a prescription for a drug, if the alternative is you buying that drug on the street and dying.”

Mental Health and Addictions Minister Judy Darcy said her ministry is working on a wide variety of evidence-based solutions to the public health emergency.

“We are going to use every tool in the toolbox,” she said. “We are not going to leave any stone unturned when it comes to safe alternatives for people to the poison-drug supply.”

Darcy said her ministry is working with the B.C. Centre on Substance Use to train more physicians in addiction and 2,100 have enrolled in a program since July.

But Darcy’s ministry must work with federal legislation that prohibits the use of controlled substances, which prevents her ministry from simply allowing doctors to prescribe heroin and substitutes at clinics, she said.

“We’re pushing the envelope within that federal context,” she said.

Jane Thornthwaite, B.C. Liberal opposition critic for mental health and addictions, said she supports making a safer drug supply available to immediately save lives, but said it must be paired with a pathway to treatment and recovery options for anyone who uses it.

“You need to have the support systems in place for these people to actually move forward,” Thornthwaite said. “If we’re not going to get to the root of the problem, then this crisis is not going to get any better. We’ll just have new people getting into the system and it could grow and grow.”

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7Feb

Daphne Bramham: B.C. opioid deaths up despite spending millions

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2018 was British Columbia’s deadliest year for illicit drug overdose deaths despite the hundreds of millions of dollars poured into mitigating the continuing public health crisis.

An average of four British Columbians died each day, a rate that has resulted in a drop in the predicted life expectancy for everyone living here.

British Columbia — and Vancouver, in particular — is the centre of the national crisis even though it has long been the testing ground for harm-reduction strategies that have included free needles, supervised injection sites and opioid replacement therapies including methadone, Suboxone and, more recently, pharmaceutical grade heroin.

B.C. has led Canada in getting free naloxone — the antidote for opioid overdoses — into the hands of emergency responders and users. It has set up free drug-testing sites.

Earlier this year, the City of Vancouver funded an expansion of a pilot project to provide pharmaceutical-grade heroin to users on the Downtown Eastside. Soon, addicts may be able to get their daily dose from vending machines.

Yet, the number of the dead hasn’t decreased, it’s only plateaued.

Also unchanged are the characteristics of the majority who died. Men aged 30 to 59 made up 80 per cent of the dead. Of those who died, 86 per cent were at home alone. Four out of every five had contact with the health care system within a year of their deaths, with 45 per cent reporting having pain. Of those dead men, 44 per cent were employed in the trades, transport or service industries.

But Vancouver is unique. It has the highest rate of overdose deaths and those deaths are concentrated in the Downtown Eastside in the low-barrier shelters, supportive housing units and SRO rooming houses that exist cheek-by-jowl with supervised injection sites, naloxone stations and testing sites.

Heading into the fourth year of a public health emergency, politicians need to set a new course.

The course that Dr. Bonnie Henry, B.C.’s chief medical health officer, plans to recommend is even more harm reduction. She said it will include “de facto decriminalization,” more pharmaceutical grade heroin, more drug testing sites, more Suboxone, more naloxone, more supervised injection sites.

On Thursday, Henry did admit that her plan will require that she “evaluate it effectively so that there are not unintended consequences.”

Chief among those unintended consequences is that if British Columbia goes it alone, it would be at risk of becoming even more of a magnet for users from across Canada, even from other countries. What drug user, let alone addict, could resist the allure of free, pharmaceutical grade drugs?

There is also a financial risk to going it alone. Last year, British Columbians’ bill for methadone and Suboxone was $90 million. The number of people on the opioid replacement therapy had risen to 22,012 people from 11,377 in 2009 and is predicted to double again by 2020-21.

British Columbians are already paying for more than 300 people who get injectable hydromorphone (pharmaceutical heroin) daily at a cost of approximately $25,000 a person every year and in January, 50 Vancouverites were enrolled in a pilot program where they get it in the cheaper pill form, which they then crush and inject under supervision.


Police speak to a man and woman on East Hastings in Vancouver’s Downtown Eastside, Thursday, Feb 7, 2019. More people fatally overdosed in British Columbia last year compared with 2017 despite efforts to combat the province’s public health emergency, the coroner says.

JONATHAN HAYWARD /

THE CANADIAN PRESS

While a provincial strategy is needed, the crisis isn’t unique to B.C. From 2016 until June 2018, more than 9,000 Canadians have died of overdoses largely from fentanyl-laced drugs.

The opioid crisis isn’t just a big city problem. According to the Canadian Institute for Health Information, hospitalization rates were 2.5 times higher in small communities of 50,000 to 100,000 compared with Canada’s largest cities.

Across Canada, hospitalization for opioid-related poisoning has risen 27 per cent in the past five years to an average of 17 a day.

While there is no good data on damage suffered by survivors of near-fatal overdoses, it’s estimated that 90 per cent of drug-overdose patients in intensive care have some sort of brain trauma. The trauma ranges from temporary memory loss to complete loss of brain function.


Chief coroner Lisa Lapointe, left, looks on as provincial health officer Dr. Bonnie Henry answers questions during a press conference about the release of the latest provincial statistics by the BC Coroners Service at Legislature in Victoria, B.C., on Thursday, February 7, 2019.

CHAD HIPOLITO /

THE CANADIAN PRESS

A comprehensive national plan is required. But it must focus not only on keeping people alive, but on helping them to get healthy.

Decriminalization — as opposed to legalization — might be part of the answer. Certainly, evidence from Portugal, which was the first in the world to decriminalize possession of small amounts of all drugs, indicates that it can be effective.

But Portugal’s success has come only because decriminalization is accompanied by strict enforcement of the amounts that individuals can possess as well as a dissuasion system that provides both a carrot and a stick to get users into treatment.

The opioid crisis is complicated. It’s been fuelled by over-prescription of highly effective pain reducing synthetic opiates, whose manufacturer convinced physicians that it wasn’t addictive.

Those synthetics then made their way to the street and while some users are unaware that their illicit drugs are laced with fentanyl, others go looking for its intense and often fatal high.

So far, staunching the flow of those drugs on to the street has proven to be little more effective than the harm reduction measures aimed at keeping users safe.

For this crisis to abate, there needs to concerted efforts on all fronts by all governments. It won’t be cheap, but then neither is the alternative.

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Twitter: @bramham_daphne

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7Feb

Drug overdoses killed nearly 1,500 people in 2018, says coroner

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A total of 1,489 people died in B.C. of suspected drug overdoses in 2018, a figure that health officials say will likely increase as ongoing investigations wrap up.

On Thursday, the B.C. Coroners Service released its latest set of data on illicit drug overdose deaths. The number of overdose deaths in 2018 edged past the 1,487 deaths recorded in 2017, though this figure could change as health officials conclude investigations of deaths recorded toward the end of the year.

Even so, chief coroner Lisa Lapointe said the rate at which people were dying continued at an “alarming rate” last year.

“The illicit drug supply is unpredictable and unmanageable, and fentanyl is now implicated in 86 per cent of overdose deaths,” she said in a news release sharing the year-end figures. According to Lapointe, the rate of overdose deaths surpasses the numbers of people dying from car crashes, homicides and suicides combined.


A total of 120 deaths were recorded in November 2018, which works out to about four deaths per day that month.

BC CORONERS SERVICE

Innovative and evidence-based approaches are necessary if we want to effect meaningful change and stop the dying. We need to be prepared to do things differently to save lives.”

Middle-aged men continue to be the largest demographic represented in the totals, with men accounting for 80 per cent of suspected overdose deaths and those aged 30 to 59 accounting for 71 per cent of deaths. A total of 86 per cent of deaths occur indoors, with spikes on days immediately following distribution of welfare cheques.


Middle-age men remain the most overrepresented group among overdose deaths.

BC CORONERS SERVICE

The number of overdose deaths in 2018 equates to about four deaths per day for the entire year. Of the 365 days of 2018, at least one death was recorded on 354 of those days.

“This latest report confirms what those on the frontline already know all too well: this crisis is not slowing down,” said Dr. Evan Wood, executive director with the B.C. Centre on Substance Use.

“If we’re going to stop overdoses from happening, we urgently need to end the harms caused by prohibition while also implementing upstream responses that address the serious health and social consequences of untreated addiction.”

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The majority of overdose deaths in 2018 occurred indoors at private residences.

BC CORONERS SERVICE




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6Feb

Vancouver hospital to send overdose patients home with treatment pills

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A bottle of Suboxone similar to the one nurses at St. Paul’s Hospital will be giving to patients discharged from the emergency department following an opioid overdose. [PNG Merlin Archive]


Handout: Providence Health Care / PNG

Patients who visit St. Paul’s after an opioid overdose will now leave the hospital’s emergency department with a supply of addiction-treatment pills.

Providence Health Care and Vancouver Coastal Health have launched a pilot program at the downtown hospital that gives these patients bottles containing three days worth of Suboxone, provided by a specially trained addiction nurse. They will form a plan for follow-up care and get clear instructions about when to take the pills.

A nurse will direct the patients toward follow-up treatment and community resources, including the St. Paul’s Rapid Access Addiction Clinic. The free clinic provides people with immediate short-term addictions treatment and transfers them to a community care provider for longer-term rehabilitation.

Dr. Andrew Kestler, an emergency department physician at St. Paul’s and the project’s co-lead, said the program will save lives.

“People who get started on opioid agonist therapy — that could be Suboxone or methadone — live longer,” Kestler said. “We know that it reduces deaths in people who have opioid-use disorder, and we know that it reduces the need for emergency department visits.”

The B.C. Centre on Substance Use will evaluate whether the pilot program leads to a decrease in overdoses, hospital visits and deaths, and to improved engagement in care.


Dr. Andrew Kestler, emergency department physician at St. Paul’s and co-lead of a project at St. Paul’s Hospital to provide take-away treatment to opioid overdose patients. [PNG Merlin Archive]

Handout: Providence Health Care /

PNG

Patients must be in a sufficient state of withdrawal to start Suboxone, which can lead to six- to 12-hour visits to the emergency department. By letting patients take the pills with them, a common barrier to treatment is reduced for the many people uncomfortable with hospital stays, Kestler said.

Those with opioid-use disorder who visit the hospital but haven’t overdosed are also eligible for the take-home Suboxone, Kestler said.

Subxone, which contains buprenorphine and naloxone, is a medicine which can stop cravings and withdrawal symptoms, and prevent death. It is considered safer than methadone, another leading treatment for opioid addiction, mostly because buprenorphine has a ceiling effect which makes it hard to overdose, Kestler said.

Typically about five or six overdose patients visit St. Paul’s emergency department each day, Kestler said. The hospital sees 10 times more overdose patients than any other hospital in the Vancouver Coastal Health region, according to Providence.

In the first 11 months of 2018, Vancouver Coastal had the highest rate of illicit-drug death of any health region in B.C., at 37 per 100,000 people, according to the B.C. Coroners Service. Of the 1,380 people who died during that period, 408 were in Vancouver Coastal.

Kestler believes the program will prove successful and could be adopted by other emergency departments.

“We’re already sharing some of our ideas and protocols with people around the province but we really hope, with this getting off the ground and having some success, that we can pave the way for broader implementation across the province,” he said.

“I think there’s obviously interest elsewhere in Canada and North America.”

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30Jan

Crackdown podcast turns B.C. drug users into ‘war correspondents’

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Executive producer Garth Mullins of the Crackdown podcast at the Ovaltine Cafe in Vancouver.


Submitted: Alexander B. Kim/Crackdown / PNG

Fed up with attending funerals for friends and loved ones, people in the vanguard of B.C.’s overdose crisis have made a podcast to file dispatches about important stories they say the public and policy-makers are missing.

Crackdown, a new podcast recorded in Vancouver, launched its first episode, “War Correspondents,” on Wednesday. It starts by telling the story of Zoë Dodd, a harm-reduction activist who confronted Prime Minister Justin Trudeau about addressing the national overdose crisis, and introduces listeners to the drug-user activists who make up the podcast’s editorial board.

It explores some of the agony caused by government inaction.

“The crisis has just taken so many people and it just keeps going, it’s not stopping, it’s spreading,” said Garth Mullins, Crackdown’s executive producer, writer and host. “I’ve lost 50 people that I came up with, at least. I just stopped counting at 50.”

Mullins, who for years used heroin and then methadone, said one goal of the podcast was to shed the stigma and challenge perceptions about people who use drugs.

“Drug users are everywhere — in your church, in your community, in your workplace — but the stereotype that you see in a lot of television production is a gritty back alley with somebody shooting up,” he said. “We don’t feel that’s a good representation.”

Mullins said media coverage often falls into two categories, one scapegoating drug users as “a destructive scourge on society,” and another which “pities drug users as just helpless waifs.”


A listening party for the new Crackdown podcast at the Vancouver Area Network of Drug Users in January.

Submitted: Alexander B. Kim/Crackdown /

PNG

With Crackdown, listeners will get to know the drug-user activists who have fought for supervised injections sites, needle distribution and prescription heroin programs. They will take back some agency by telling their own stories.

Mullins said the podcast will remain grounded in research and data from its science adviser, Ryan McNeil, who is an assistant professor in the faculty of medicine at the University of B.C. and a research scientist at the B.C. Centre on Substance Use.

The podcast is aimed at Canadians impacted by the overdose crisis, but Mullins said he hopes it also reaches the ears of those in charge of making policy that could save lives, who he believes the media often let off too easy.

“The other audience for us is Justin Trudeau, the federal cabinet … Doug Ford and all the people who are running Ontario and trying to cap safe-injection sites,” he said. “The audience is John Horgan and the government of B.C., who are not acting fast enough to do something about this — the people who have their hands on the levers.”


An editorial board meeting for the new Crackdown podcast.

Submitted: Alexander B. Kim/Crackdown /

PNG

Dean Wilson, a longtime activist who in 2011 successfully fought a federal government appeal to shut down the Insite supervised injection site, sits on Crackdown’s editorial board and brings two decades of Downtown Eastside knowledge to the podcast.

“We’ve always been written about and the story has always been about us, but the narrative has never been ours,” Wilson said. “This is a way of setting our own narratives.”

New episodes are released on the last Wednesday of each month, and can be downloaded on most podcast apps or streamed at crackdownpod.com.

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23Nov

First Responders: When the helpers need help but are afraid to ask

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There is a push on in B.C. to provide more mental health services to first responders, the people we depend on to help us in times of trouble, but who often shun asking for help themselves.

Adding to the traditional grimness that B.C. paramedics, police officers and firefighters endure — fatal accidents, devastating fires, murder scenes — is the opioid overdose crisis that has killed more than 3,500 people have died since January 2016. Thousands more have been saved by injections of the overdose-reversing medication naloxone.

“We will go to a call involving a fentanyl overdose, we will give the person naloxone. When they regain consciousness, they will have no idea what happened. They are often combative and often will refuse hospitalization. Sometimes they are in hospital gowns with the hospital tag still on because they just got released,” says Matt Johnston, a firefighter in Metro Vancouver.

“You go back to these repeated customers, and pretty soon it will wear on your spirit and you (think): My ability to be compassionate against this patient is next to nowhere.

“So when you are going to three or four calls of overdoses per shift, all of a sudden the world doesn’t look as shiny any more. And it has a way to generalize to other areas of your life where you are more cynical about human nature.”

Johnston is acutely aware of the effects of trauma on first responders. Before becoming a full-time firefighter in 2012, he graduated from UBC with a masters in counselling psychology and opened a local practice that helped at-risk youth. Even though he worked as a registered clinical counsellor, he still occasionally struggles when responding to calls in his new profession.


Matt Johnston is a full-time firefighter and a trained mental health clinician.

Arlen Redekop /

PNG

Combining his two worlds, Johnston now sits on the B.C. First Responders’ Mental Health committee, which has brought together management and workers from a variety of agencies to develop a provincewide best practices guide and online resources for problems such as suicidal thoughts and depression.

Research has shown that first responders are at an increased risk of mental health problems. A 2017 national study by University of Regina psychology professor Nicholas Carleton that surveyed nearly 6,000 dispatchers, correctional workers, police, paramedics and firefighters found 44.5 per cent showed signs of least one mental health disorder, much higher than the average of 10 per cent in the general population.

In April, the provincial government announced it was removing barriers to helping first responders get mental health help. PTSD and other mental health conditions are now presumed to have been caused by the nature of their work, so first responders no longer have to prove such illnesses happened on the job.

“First responders, sheriffs and both provincial and federal correctional officers who experience trauma on the job and are diagnosed with a mental disorder should not have the added stress of having to prove that their disorder is work-related in order to receive support and compensation,” Labour Minister Harry Bains said at the time.

This is a significant policy change, said Sean Gjos, owner of Boreal Wellness Centres in Yaletown, which is developing a new trauma counselling program for first responders.

“For many of these individuals, their normal day-to-day work life is dealing with situations that, for most of us in the general public, is one of the worst days of our lives. … And over a period of years, all of those experiences can accumulate and be a really heavy burden for first responders,” said Gjos.

“So making it easier for them to access appropriate care is a huge win, and long overdue.”


Sean Gjos

Arlen Redekop

The mounting number of suicides by first responders in B.C. showed that change was desperately needed. A website kept by a retired paramedic, Lisa Jennings, counts nearly 60 suicides by police and corrections officers, paramedics and firefighters over the past three years.

And yet, for a province with about 17,000 police officers, firefighters and paramedics, the number of claims made to WorkSafeBC for mental health problems is low. There were 269 claims in 2017: 84 allowed, 41 refused, and the rest abandoned.

The Labour Ministry said it is too early to know whether April’s rule change will substantially boost these numbers.

Why are there so few claims if research suggests almost half of first responders have some type of mental health injury? Stigma. This stops many in paramilitary, “tough guy” careers from asking for help, experts say.

“We did a survey to find out what first responders’ current attitudes were about mental health, about seeking help, and about stigma. And the response we got back from that was: Yes, stigma does exist in these organizations,” said Trudi Rondou, WorkSafeBC’s senior manager of industry and labour services, who chairs the First Responders’ Mental Health committee.

Last year, the committee launched the “Share it. Don’t Wear It” campaign, featuring the stark faces of first-responders covered with chilling words, such as: “There’s this heavy feeling. It’s more than a bad call or a bad day. It’s like all the time.”


The B.C. First Responders’ Mental Health committee launched this “Share It. Don’t Wear It.” poster campaign. A recent survey of first responders found a majority changed some behaviours after seeing posters like this one.

Submitted photo /

WCB

In a survey this year, 62 per cent of respondents said they were more likely to speak up for help as a result of the campaign, said Rondou.

That’s a promising sign for first responders, whose most common mental health diagnosis is depression or anxiety, with PTSD making up just seven percent.

But to whom do they turn for help, once they are ready to ask?

Johnston, who has done mental health outreach work with firefighters, has designed a two-day course for mental health professionals interested in working with first responders. Over the past year, 250 clinicians in seven B.C. cities have taken the course.

Given how hesitant first responders are to seek help, the course gives clinical counsellors tips on the appropriate language and approach to use so that these workers will continue to return. Through his website First Responder Health, Johnston has also created a telemedicine option that links first responders in rural communities with trained clinicians.

“First responder jobs can be brutally difficult,” said clinical psychologist Mary Ross, who has taken Johnston’s course and whose expertise includes PTSD. “And more than I think the public appreciates, there are very kind, well-meaning, sensitive people joining these organizations and some of what they deal with impacts them hugely and, unfortunately, makes some really, really sick.”

Responding to the increased number of calls where people have died or are in need of repeated intervention because of the opioid crisis makes it even more difficult for first responders to find a balance between staying emotionally unattached at work and being emotionally open in their personal lives.

“You create the barriers you need to stay sane (at work),” said Ross, who works at Boreal. “Then how do you go home and be a dad and a husband when you’ve been building walls all day?”

Gjos, who worked in financial management and had several health care organizations as clients before opening Boreal, said first responders, veterans and nurses make up 40 per cent of the clinic’s patients. He expects that the 10-week, outpatient trauma program that Boreal is developing will be popular with first responders, and could also help emergency-room doctors and nurses, dispatchers, correctional officers and Crown attorneys.

Gjos is in discussions with WorkSafeBC about his clinic becoming a recommended provider, which would mean those seeking counselling there for approved claims for workplace injuries would have their sessions covered financially.

“We are trying to help people who have had traumatic experiences to develop tools and become more resilient so they become more functional across all layers of their life,” Gjos said, adding that vocational rehabilitation experts work with patients who have taken a leave of absence.

“We are collaborating on their return-to-work path. It is a really important aspect, especially in safety sensitive jobs.”

Ross, who has been a clinical counsellor for 20 years, believes first responders are more willing to ask for help than they were in the past.

“Now it’s a little easier to do it more openly and have the support of your workplace behind you in a way that wasn’t quite there before,” she said, but added that more work needs to be done.

Johnston believes changing the language from “disorders” to mental health “injuries” will encourage more first responders to come forward for help, just as they naturally would with an injured arm or leg.


Matt Johnston began his private practice, Centered Lifestyle Services, which offers counselling to first-responders, in 2007.

Arlen Redekop /

PNG

He also senses a change from the dire situation a few years ago, when his department lost two members to suicide in just seven weeks, to more encouraging times now.

For those in the early stages of feeling down, Johnston has a few recommendations: Get more sleep, which is often a challenge for those who work shifts; stay connected to friends and family, which can also be difficult when you work nights and weeknights; and have a physical outlet or hobby that can clear your head. For Johnston, a former Team Canada distance runner, it is going for long jogs.

For those more mired in workplace gloom, he hopes his take-away message for first responders is that “taking a knee” in counselling will make them more confident in other elements of their lives.

“If firefighters can understand that idea that it will help you become stronger in your job and your personal life, not weaker.”

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Twitter: @loriculbert




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13Nov

New study sheds light on who’s dying in B.C.’s opioid crisis

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Vancouver Fire Department Medical Unit responds to an unresponsive man after he injected a drug in the Downtown Eastside in Vancouver, December, 9, 2016 in this file photo.


RICHARD LAM / PNG

The first snapshots from a project aimed at providing a better picture of people at greatest risk of illicit drug use reveal that an average of nearly 10 Canadians fatally overdosed each day between 2016 and 2018.

Statistics Canada says the data from the Public Health Agency of Canada show British Columbia is facing the worst of the crisis.

Further data from the agency reveal victims in B.C. range from employed people who have never had contact with the justice, social assistance or hospital systems to those with little work history and long-term legal and social issues.

B.C. Coroners Service numbers included in the study show overdoses leaped from 293 in 2011 to 639 by 2016 and nearly three-quarters of those deaths involved 25- to 54-year-old men.

Of those at risk, the study shows roughly one-quarter were hospitalized in the year before their deaths, more than 40 per cent visited an emergency room at least once in that time, and three-quarters of those who had contact with police for an alleged crime died within a year of that interaction.

The data are from the Opioid Project, a partnership between numerous agencies including Statistics Canada, British Columbia’s Health Ministry, the B.C. Coroners Service and several departments within the City of Surrey, including its RCMP detachment and fire department.

Surrey’s high profile in the project stems from its efforts to develop a real-time overdose reporting system to rapidly respond to areas where a bad batch of drugs may be circulating.

Surrey fire Chief Len Garis, who is also an assistant professor in the school of criminology and criminal justice at the University of the Fraser Valley, said the findings should help focus prevention programs.

Surrey Fire Chief Len Garis.


Surrey Fire Chief Len Garis.

Ric Ernst /

PNG Files

“What we’re trying to do is determine the trajectory of the individual who died so we can find out what his or her pathway was to this particular issue,” he said.

“So far, what we know is that the majority of those individuals who died, their contacts with police were for shoplifting and for the administration of justice, basically failing to comply with an order and for breach of probation,” he said.

That information suggests the justice system needs to try a different approach, Garis said.

“It’s a vicious cycle within the justice system before they die. So we have to change the way we do business.”

He said more resources, such as supportive housing, recovery programs and addiction management, are also needed for people who shoplift to support their addiction.

Garis said the biggest surprise for him was that two-thirds of the people who fatally overdosed had no contact with police.

The data from 2016 also show nearly 25 per cent of people worked in the construction industry and almost half of them were in building maintenance, waste management and support services.

The B.C. Coroners Service recorded more than 3,400 overdose deaths in the province between January 2016 and September 2018. The number of fatalities decreased by 27 per cent in August compared with July.

The top four drugs involved in illicit-drug deaths were fentanyl, cocaine, methamphetamine and heroin.

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