Introduction


by: Carole Fawcett (www.wordaffair.com)

It has been an interesting time writing these pieces for the Vernon Shares project.  I hope when you read them, regardless of your thoughts and beliefs that you will share these stories with others.  If we work together, we can help to create an educated awareness concerning the opioid crisis helping to remove the stigma and being more open to reaching out and helping. We can change the one-sided narrative and start a dialogue with more understanding and compassion.

The blaming and shaming attitude of the “just say no” movement (Nancy Reagan, circa 1986) still prevails. It makes those who use feel even worse than they already do – which may be why they use drugs in the first place, to numb the feelings of unworthiness. 

Almost 1500 people died in BC of an opioid overdose in the past year, according to the BC Government.  232 of those people were in the area that Interior Health covers and in Vernon, there were 24 deaths.  These numbers surpassed vehicle accident deaths and also the deaths of those who contracted AIDS and died in 1991. (at the height of that health crisis) Just as a frame of reference, in 1991 in Canada, 1800 people died of AIDS……..across Canada. So you can see from that comparison of numbers that the deaths from opioid  overdose is very high, as it reflects numbers in British Columbia only.

In Portugal, in 2001 they decriminalized drugs, cocaine, heroin, and other drugs. They decided to treat possession (small amounts) as a public health issue.  The drugs remained illegal, but getting caught with them meant a small fine and a referral to a treatment program. There would be no jail and no criminal record. This decision saved lives and the opioid crisis stabilized. They worked together with the addict and paved the way for the likelihood of success in overcoming the addiction.
This systemic change flowed throughout the country, right down to the average person and people were speaking more respectfully with deeper understanding, of those who had addiction challenges.

It has been proven that the authoritarian approach does not always work, and in fact, can exacerbate the situation. Granted, there have to be some rules and regulations, but they need to be used as guidelines with flexibility built in.
We must remember that those who use drugs are all someone’s child, mother, father, sister, brother or friend. They are human beings who did not purposely choose to become addicted to drugs or alcohol. 
The circumstances of their life created this path, and given that current treatment models have low recovery rates, we must step up and provide the support so that all our citizens can live with dignity and self respect. Perhaps it is time for change.  Let’s trade our judgment for compassion.

The Seniors


by: Carole Fawcett (www.wordaffair.com)

There were twelve of them from the Seniors home who agreed to meet and chat about the Opioid Crisis with me. I had put up a sign inviting them to have a discussion about the issue, so they chose to meet with me over coffee after their exercise class. They ranged in age from mid-seventies and into their nineties.  They live in independent suites and eat communally at breakfast, lunch and supper. 

It was a relaxed meeting, with guarantees that nobody would be identified and that this confidentiality also included the location.

As we all know, there are generational differences.  The folks who live in most senior residences represent the Traditionalist Generation – usually born before 1946.  A lot of them survived WWII, the Korean War, and The Depression. 

They may have been immigrants, coming to Canada to start over again. When they were growing up they may have experienced difficult times, but for a lot of them, they also experienced times of prosperity. 

It was interesting to note that when the discussion started, there were a couple of people who reacted strongly and came from what seemed like a place of judgment. Those folks may represent the old black and white work ethic notion that if you work hard, you will get ahead and there is no excuse, as you were dependent on yourself and nobody was going to step in and help.  They may have believed that using opioids is a choice and that it would be handled best by limiting how many times (as an example) a person should be given Naloxone. 

We discussed the use of Naloxone and I shared that one of the people I had written about had been given this life saving drug four times in one weekend.  That initially brought about a concern of the cost of this service and some discussion about there being a limit as to how many times it was offered. 

By the end of this shared discussion, there was more compassion and understanding with the realization that a life can be saved and subsequently helped, no matter how many times it might take. 

One of the seniors had an awareness of the fact that there are also mental health issues that may walk alongside the drug dependency.   As a retired professional herself, she was aware of the importance of education and support for anyone who may be caught in the opioid crisis.   There was agreement from all with this point.

One of the participants suggested that overuse of pharmaceuticals and ease of prescription writing by Physicians may help to create an addiction – due to pain issues as we age.  Although it was also stated that Physicians were becoming more aware of how these narcotics could have long term impact if too many were prescribed.

One person shared they took Percocet for severe arthritic pain, but that she monitored it closely and did not over-use.  She stated her Doctor had suggested she try an over-the-counter pain medication first, before resorting to the narcotic. 

This communal coffee chat was a great success, as several of the attendees shared that they had learned a lot and one person stated that their views had definitely softened. They shared that it gave them a deeper understanding of opioid addiction, with the realization that it crosses all socio-economic boundaries and that it can impact everyone, not just those living rough.

The Accident


by: Carole Fawcett (www.wordaffair.com)

It was 2008 when Nancy was seriously injured in a boating accident. She had unknowingly broken her back and already had the pre-existing condition of spinal stenosis.  (Spinal stenosis is a narrowing of the spaces in the spine and can frequently put pressure on the nerves that travel through the spine).

The first Physician she saw did not physically examine her, or send her for x-rays.  She was given a prescription for 60 Percocet (an opioid pain reliever) along with muscle relaxants.  Two weeks later, having finished the prescription, Nancy decided to see a
different Dr., as she found that she was still in an inordinate amount of pain.  She was given a steroid injection and another prescription for 120 Percocet’s.

Two weeks after that, her pain was at the same level and she was then dependent on Percocet to be able to move enough to get out of bed, drive her two young children
to school as well as their extra-curricular activities.  She worked part time, took care of the children and the home while her husband worked out of town.  It was daunting to try and function with the level of pain she was living with.

Nancy said, “It took me three Percocet’s to get out of bed and another three to get to Physiotherapy by 10:00 a.m.  I was using 15 Percocet per day on average.  I visited the Dr. once a week with not much difference in the level of pain.  It was debilitating.”

Nancy found another Doctor and demanded that she have an MRI to see what was going on.   She learned she had broken her back in five places, had herniated discs in three other places, as well as having nerve compression in her spinal column.  While it was a relief to finally have an answer, she was told she was not a surgical candidate due to where the worst damage was located in her spine, plus she smoked cigarettes at that time. 

Nancy then spoke with a Pharmacist to see if a medication change may help.  He told her that he was very concerned with the high dose of Percocet she was taking and suggested she ask the Doctor for a longer acting pain medication, Oxycontin.  She followed through with this suggestion and was given a prescription for three  80mg of oxycontin per day, using Percocet only when absolutely necessary.

While her pain did not lessen, she began to improve in physiotherapy, although she and the Physiotherapist still felt frustrated with the level of pain she was experiencing.

This continued for eight months.  Nancy’s behaviour was changing too.  Her fatigue from the medication was so great that she fell asleep during her daughter’s elementary Christmas Concert.

She went on short-term disability, couldn’t keep up with her social commitments and she began to notice that she was having memory lapses in the middle of the day.   The impact of the medication was becoming more and more noticeable.

Finally a close friend of Nancy’s called her on her drug use, when she once again fell asleep in her salon chair as the friend was styling her hair.  She pointed out that Nancy had become a different person and pushed her to learn what the medication was doing to her. 

Nancy  saw a Doctor who was filling in for her Doctor, and who, upon reviewing her medications stated, “If you were to get hit by a train when you leave this office, there are not enough pain meds the hospital could give you….. your tolerance must be so high!”

Nancy said, “I was shocked.  What was she saying?  That I, the perfect picture of a suburban house-wife and mother was an addict?”  It was difficult to comprehend.    The Doctor then told Nancy she had two choices to make:  taper off of the oxycontin, which would take a few months and have some undesirable side effects, or go on a methadone program.

“Me – go on Methadone?  Wasn’t that just for junkies?”  Nancy shares she was shocked.  She learned that methadone is a tool to help people who use drugs, (pharmaceutical drugs included) to use less drugs and hopefully cease altogether.  She was horrified to be one of “those” people! (in her mind at that time) The realization was hard, as it caused her to re-examine her beliefs about “drug addicts”.  

In the end, Nancy chose to taper off and as predicted by the doctor, it wasn’t easy.  But she is proud to share that she did.  It has been approximately 10 years since the ‘missing’ year (as she explains).   She began to become involved in her community and sports again, as well as returning to a full-time academic program and working.  She was also able to repair any relationships that had been damaged by her addiction.

As Nancy herself says, “It has become a speck in the rearview mirror of my life.  A life I live fully and completely.  I am grateful for the opportunity to have a choice in my physical well-being again!”

Paramedic Perspective


by: Carole Fawcett (www.wordaffair.com)

George has been a paramedic for 30 years.  There isn’t much he hasn’t seen or experienced, as he worked Vancouver’s infamous east side in the 90’s during the Heroin crisis.   As a result, he shares that his job has made him appreciate his own life.

 George says that “real people with real problems that include mothers, fathers, sons and daughters, brothers and sisters, grandparents, grandchildren from both sides of the tracks are impacted by the opioid crisis.”

In speaking of drug dealers, he states, “….the pharmaceutical distributors at the street level are highly unreliable. (Users are never sure what they are getting) A lot of the drugs that are used are for physical, emotional and psychological pain and they can be mixed with other drugs that are not identified.”

It was in the 1800’s that opium derivatives became widely used as pain relievers.  This includes heroin which was used for medical use before Physicians understood that it was addictive.

The BC Emergency Health Services statistics show that paramedics responded to 23,662 overdose/poisoning calls in 2018.  285 of those calls were in Vernon and 928 were in Kelowna.

George and his co-workers use Narcan to treat people who overdose on opioids regularly in their job.  George shares that “….paramedics rely on airway management and ventilation skills to deliver oxygen.  During the early stages, resuscitation from opioid overdoses, narcotics such as Fentanyl depress the respiratory center of the brain causing victims to stop breathing. Once this is managed, the antagonist drug Naloxone (Narcan) can be administered to compete with narcotics at the opiate receptor sites of the brain. As the effects of Narcan last between 45 to 90 minutes, overdose victims are at risk of suffering from the Narcotics still in their system, as it can last from 4 to 8 hours. Narcan provides an almost immediate fix, but is only a short term solution and the victim is likely to suffer sudden withdrawal thereby suffering the pain they were self-medicating for. They are now more motivated than ever to get the next fix. Such is the perpetual cycle of addiction.”

Overdosing is not a criminal act.  The patient is free to get up and leave after being resuscitated, and many do – going in search of their next fix. 

George believes that we can offer help and assistance to those who are addicted and want the help and also acknowledges that there will always be a small percentage of drug users who do not want help. 

He states, “at what point do we value the health and safety of the community above the rights and freedoms of the individual?”  He believes that we have to “make sure people are safe and have the necessities to survive, but that there has to be some accountability and rules for it to work.”

As a paramedic, George believes that safe injection sites are “a step in the right direction.”  He says that drug users frequently share needles and this is how diseases such as HIV, Hepatitis B and C can be spread.   A lot of drug users don’t realize that other shared tools, such as spoons, cotton filters and even water can spread disease as well.  Safe Injection Sites could lessen this and have trained professionals on hand to treat any adverse drug reaction.

Parental Heartache


by: Carole Fawcett (www.wordaffair.com)

Sharon didn’t know that when she gave birth to baby Brian that he would die at 19 years old of Gioblastoma.  She walked alongside him when he had his brain surgeries and his subsequent cancer treatments.  That was Sharon’s first loss.  It impacted her in ways she is still coping with to this day.

Her daughter Monique was a painfully shy child.  She started using drugs at age 21 with her boyfriend who was a heroin addict.  She became pregnant and by the time the child was born, the boyfriend had left.  She was trying to raise a baby on her own and wasn’t a very good parent.  Her boyfriend’s Mother took over as the baby’s guardian and has raised her, together with Sharon for the rest of this baby’s life.  This child is now a teenager and very loved by both sets of Grandparents.

Monique continued to use drugs and was a sex worker in order to earn the money for the drugs.  She had two more babies, who were adopted by the same adoptive parents.  One was born in a hospital and one was born in a toilet in a motel.  Both were drug addicted at birth.  Monique still lives on the street, sleeps in a car and barely survives.  Sharon has lost contact with her, despite her best efforts to stay in touch.

Sharon’s third loss was when, as a13 year old, her daughter Jamie started to use drugs and get into trouble.  Jamie became an angry, impossible-to-deal-with teenager with erratic behaviours, lashing out at her Mom and her step Dad to the point she had to go into foster care.  But, by the time she was 16 she was free of drugs, returned home, graduated, and went on to train in a professional career that would have her working with children.   

Sadly, she was in a very bad car accident, suffered head injury, had her jaw realigned and had to wear hearing aids.  Jamie was put on oxycotin (3 months prescription at a time).  When her physician cut her off her meds suddenly, she turned to street drugs to deal with the pain.  She has spiraled down from there, getting involved with fraud activities, spending time in jail and once again becoming involved with drugs.  Her boyfriend overdosed on fentanyl and died. 

Just as she was preparing to speak to a drug counselor who had agreed to attend her parent’s home, Jamie overdosed and Sharon had to do CPR.  At this writing, Jamie is still using and now lives on the street, having recently been kicked out of her rental. It is unknown if she has another place to live.

Sharon and her husband Bob, did everything for the girls.  They tried to help them, bought them groceries, paid the rent on a few occasions, drove them to medical appointments and reached out with love in every conceivable way.  But despite their best attempts, nothing worked.  Each time, their daughters would climb back on to the spiral. Bob has done his best to be strong throughout all this, but as he says, “it’s hard to be the rock, when the rock is crumbling too.”

Sharon shares that the guilt and the shame is at times overwhelming for both of them.  She has spent years trying to figure out why these two girls went down this path. She has cried oceans of tears and she shares “there have been times when I didn’t know if I could go on any longer and there are times when I am devastated by events and it feels like my heart is crushed.”

Mary’s Tent


by: Carole Fawcett (www.wordaffair.com)

Sitting across from me at the Upper Room Mission is Mary. It is easy to see that her teeth are missing;  but it doesn’t stop her from smiling.  Her soft eyes measure you with each piece of information she shares. 

 Mary’s 35 years on this earth have been a long and unimaginably difficult journey. Up until the age of four, she lived with her parents on a Carrier Nation reserve in Smithers, BC.  She now lives on the street.  All her worldly belongings can be pulled behind her bike. 

 “People think it is an easy life, living on the street, but if people were in my shoes, they have to ask themselves what would they do?” 

Mary walks or bikes five to eight miles in order to have breakfast, lunch or supper during the week at the Upper Room Mission.  She can also have a shower and do her laundry there as well.  She frequently misses breakfast due to the length of the trip from where she currently lives, and if overnight there has been a fresh snowfall.

By choice, she lives in a 9-person tent, on private land, just outside of Vernon with her boyfriend.  They have managed to set up a safe-from-the-elements tent space, with wooden pallets, blankets, candles and a propane heater.  She says they are warm enough.  She doesn’t want to live at a Shelter, as she shares they are scary places full of drama and “your stuff gets stolen.”  She prefers the tent life for now as she says she “feels safer and it is less stressful.”  

She had to administer Naloxone to another street person, but has never had to have it used on her.  She has three Naloxone kits and they are never far away from her.

She started to use drugs at age 13 (crack cocaine, marijuana, methamphetamines, alcohol).   She spent seven years in one foster home, but when the foster Dad died, she and her brothers were separated. One of her brothers has since died of a Fentanyl overdose. She then spent time in 14 different foster homes and says she was angry and difficult to get along with, having been sexually abused many times as a teenager.  She was sent to an alternative school down at the coast for teenagers who had behavioral challenges. 

She said she was “heavy into crystal meth” from age 18 to 23, calling them “my party years.”  She met her husband in a shelter and together they had four children.  She has three sons and a daughter.  Her sons live in foster care and her daughter is with her ex in Northern BC.  Her daughter is five years old and Mary says, “my little girl is my life.”

She hasn’t spoken to her daughter for quite a while, but she has tried. She says she would love to be back with her family.  This is her third winter living on the street.  She was embarrassed when she shared that she has to steal things in order to survive sometimes and she feels really bad about that, “but ya gotta do what ya gotta do to survive, and I won’t panhandle.”

At the moment, Mary uses crystal meth and heroin.

She is relieved and looking forward to having her own place when the new housing facility on 33rd street is finished.  It means she won’t have to spend a fourth winter in the tent.   She hopes that having her own space will help her to find peace in her life with the opportunity to stop using the drugs.

Pharmacist, Jody Cunningham

by: Carole Fawcett (www.wordaffair.com)

According to Pharmacist Jodi Cunningham, all medical professionals are becoming more aware of the addiction potential of prescribed opiates.  As she states, “Some people are at greater risk than others as they have some of the factors that may predispose them to addiction.” 

Jodi says she sees that people are “more aware of the potential for addiction and that there is a hesitancy to use prescription opiates as often for treatment of pain.  When they are used, it is usually for a more limited duration.”

She says that when a medical professional becomes concerned about a patient becoming addicted, that there should be other alternatives offered.  “When you take away medications that someone has potentially become dependent on, without offering alternatives for pain management (as an example), you increase the risk of that person seeking out more dangerous opiates.  We must not be a part of the problem by cutting off pain medications without offering a step-down plan. (easing them off slowly.…transitioning to less risky pain medications and implementing other strategies to manage pain.)”

Health Canada has stated that whenever a patient is given an opiate, they must be provided with an information sheet.  As well, prescription opiates now have a bright yellow sticker attached to them that reads, “Opioids can cause DEPENDENCE, ADDICTION and OVERDOSE.”

Jodi further states, “We have to be diligent about monitoring and helping patients know and recognize the signs of addiction.  We must not avoid discussing this issue and have open lines of communication. We need strategies to lessen the risk and stop the losses that we have seen with opioid overdoses.  Again, we need to focus on the underlying issues and provide increased access to services to help remove the stigma.”