More than 40 people gathered in Agassiz’s Agricultural Hall Tuesday (April 30) to hear expert opinions on B.C.’s opioid crisis and share their thoughts on how drug use and overdoses have affected their community.
“In this three hour period, we’re not expecting to change the world or solve all the problems,” Tara Taggart, a community health specialist with Fraser Health, said before the meeting. “But to just have conversations about it and listen to each other.”
Taggart is a member of the Agassiz Harrison Healthy Communities Committee and one of the people who helped organize the Tuesday event. Officially put on by the Agassiz Ministerial, the night was funded by a grant from the University of Victoria intended to bring more awareness to opioid use in the community.
“The purpose of these events are to have dialogue around the topic of opioids,” Taggart said. “That’s part of the process of addressing the crisis that we’re in. If we’re not talking about it, if we’re not shedding light on it, it becomes something quiet.”
“We’re trying to bring it out into the light.”
The evening was divided into three parts: a panel discussion, round table conversations with attendees, and a question and answer period.
Sitting on the panel was Dr. Robert Fox, a doctor at Seabird Island; Tim Chapman, a substance use counsellor at Agassiz Harrison Community Services; Const. Brock Pascuzzo, a former Agassiz RCMP member and now a member of Chilliwack’s drug section; and Liane Radmore, a harm reduction coordinator with Fraser Health. All shared their thoughts on how they’ve been impacted by substance use in their professional or personal lives, and in the community.
For Dr. Fox, opioids created a professional dilemma as over-prescribing doctors helped patients develop a dependence on the drug.
“When I was in medical school, back in ’97, ’98, I can remember the lecture when an expert came and talked to us about prescribing for people who are in pain” he said. “The take-home message was don’t be afraid to prescribe them, and as long as the patient tells you they are still in pain, then increase the dose.”
“We now know for much of us in the medical community, we got lied to,” he added.
For Dr. Fox, the opioid crisis has come in three stages: over prescription of opioids, patients turning from prescription drugs to street drugs and finally the introduction of fentanyl and the increase in overdoses.
Const. Pascuzzo also talked about his professional experience with opioids, although his background is in catching drug traffickers and dealing with organized crime around drugs.
“The stuff that sticks with me is actually from my time in Agassiz working as a police officer and dealing with at-risk youth,” he said. “Five girls stick out in my head, and three of them are dead.”
“Unfortunately, this wave of evil, of this fentanyl problem has taken some of those girls away,” he added. “They never got away from it.”
For Chapman, on the other hand, the connection to opioid use and addiction was much more personal.
The community services counsellor had been addicted to heroin for 20 years, using opioids for the first time at 14.
“I’m 61 now, and I remember the day when I was 14 where I felt happy. I felt like everybody else felt,” Chapman said. “Eighteen years later, I was able to crawl out of that abyss, and being a drug addict, an opiate addict, I’ve crawled back in a couple times.”
But Chapman had also seen the effect of substance use in Agassiz and Harrison through his work as a counsellor.
“When I came to Agassiz Harrison Community Services, there were no open files,” he said. “I started going out and letting people know we were there and they could get help. In that one year, I have over 95 clients.”
“This is just in your little town,” he added. “We have a problem. We have a problem in every town.”
Through Chapman’s talk, he touched on the importance of a concept called harm reduction, something that Radmore discussed in more depth during her portion of the panel discussion.
“We speak of folks as though they’re the only ones on the planet who use substances,” Radmore said. “We’ve been using substances on this planet for hundreds of years. Hundreds and hundreds of years. And not everyone who uses substances is addicted. Not everyone uses substances in a problematic way.”
The importance of harm reduction, she explained, is to meet people where they’re at and provide them with what they need to be safe, whether that’s sterile needles or overdose kits.
This method has become widely discussed during the current health crisis, as many overdose deaths are happening with people who are using drugs alone at home.
“We can’t tell who’s at risk,” she said. “I can’t look around this room and go, ‘Oh she’s at risk.’
“One of the ways to reduce stigma is to talk about it with everybody. To really talk about the fact that we’re all at risk, here are the things we need to do to be safe and to be able to have open conversations about it.”
The importance of harm reduction sparked a fair amount of discussion among attendees, and seemed to be an overarching theme of the night, as did round table discussions on the history of substance use and a fear of stigma.
We’re in the round table discussion part of the evening. People are talking about shame, fear of stigma, the history of substance use, the importance of education and how to handle drug use. pic.twitter.com/Wyezys9iOI
— Grace Kennedy (@gracekenn) May 1, 2019
The topic of seniors and drug use was also brought up — an important discussion for the Agassiz and Harrison areas, as nearly a quarter of all residents in Kent and more than a third of all residents in Harrison are over the age of 65.
For Dr. Fox, the best way to notice substance use in older adults who may not feel comfortable saying they are addicted to opioids is what he calls “pharmacovigilance.” This is also the best way to prevent others from using opioids prescribed to seniors without them knowing.
Pharmacovigilance includes things like providing pain medication in weekly blister packs, so that missing pills can be spotted more quickly, and also giving out fewer pills at one time.
The medical system also keeps tabs on which doctors have prescribed which medications for which patients, so a patient can’t go from doctor to doctor searching for more opioids.
But for patients who may be addicted, the best options for doctors is to know how to spot the signs and be able to approach the senior about steps that can be taken to help them deal with their addiction, Dr. Fox said.
Pascuzzo also noted that seniors can be taken advantage of by drug traffickers, particularly if the seniors do not have family nearby or regular check-ins from a health practitioner.
“It’s usually somebody who’s lost their spouse and their family is no longer around,” he said. “What normally happens is a drug trafficker moves in, or people associated with a drug trafficker move in and take advantage of that person.”
By providing things like sexual favours or purchasing food for the senior, Pascuzzo said, drug traffickers can take advantage of the senior’s money or home.
“I think the only thing to combat that is to just be aware,” he said. “There needs to be people being aware and vigilant of what’s happening.”