By Isabelle Southcott | firstname.lastname@example.org
Small town fentanyl crisis
There’s a growing problem with opioid use and drug addiction in Powell River, and it’s claiming lives.
That’s according to two staffers at the Powell River General Hospital’s Mental Health and Addictions Services program. Nora Koros is the manager, and Kate Hodgson is clinical coordinator.
“We get a lot of dirty drugs in Powell River,” said Kate. By that she means drugs mixed together. “People are not choosing to use fentanyl. It’s ending up mixed in with other drugs like heroin, ocycontin, cocaine and other powdered drugs.”
Province-wide, overdoses claimed 922 lives in 2016 making it the deadliest overdose year on record. Fentanyl, an opioid 100 times more potent than heroin, has been blamed for many of the drug overdoses.
Powell River had six drug overdose deaths last year. Community Coroner Steve Hunter confirms that four were caused by fentanyl. To put this into perspective, Nora says we usually have two drug overdose deaths a year here.
If there is a bright spot, it is that finally this crisis is receiving attention.
“So many people in Powell River have issues with addictions,” said Kate. “This is way bigger than fentanyl, but fentanyl is thrusting it into the spotlight.”
Prescription opioids trigger some
For the past 15 years, opioids have been prescribed relatively liberally for people who have pain, said Dr. Anna-Marie Maguire, a local physician whose area of specialty focuses on opiate substitution therapy in addiction medicine.
“It’s been a trend in medicine. Doctors know they can improve the life of a person who has chronic pain. I think it’s done without realizing how easy it is to start and how hard it is to stop,” she says.
Opioids prescribed for chronic pain are codeine, morphine, hydromorphone and oxycontin and the fentanyl patch.
But things are changing.
“I see doctors post-op only prescribing opioids for a very short period of time rather than the longer term prescriptions that they did five or ten years ago,” said Nora.
Some people misuse opioids because their brains have developed an addiction. And, says Dr. Maguire, the disease of addiction starts in adolescence when the brain is vulnerable to substances like nicotine, marijuana and alcohol. Addiction is believed to be a chronic relapsing mental health disorder.
“People continue using opioids and, as with any addiction, there is a lot of shame and guilt,” said Nora. “They use alone and no one knows they have these addictions and that increases the risk if they overdose on fentanyl.”
Managing overdoses is possible
Naloxone is a drug that can reverse opioid overdose and is sold under the brand name of Narcan. BC developed a take-home Naloxone program to help save lives.
“Narcan is readily available and we distribute it through the [Sunshine Coast Treatment Services] clinic,” said Dr. Maguire, noting it’s also available through pharmacies. “A lot of overdoses in Powell River are getting managed by the users themselves and not even getting into the emergency room.”
Sunshine Coast Treatment Services has been providing individual physician-directed methadone treatment services in Powell River since 2002.
Government is stepping up
An extra $165 million in funding for a specialized mental health and addictions team to provide support for people using illicit drugs was announced earlier this year as part of the provincial budget.
The money allows for the creation of an intensive case-management team to assist people with moderate to severe substance use connect with health care services in a preventative, proactive manner.
“If we can intervene early enough that prevents them from ending up in hospital in a crisis situation,” said Nora. The provincial government also announced two new transitional beds for Powell River women located in Courtenay. Powell River men already have access to recovery beds in Courtenay.
“The need was there before the fentanyl crisis, but now it is being recognized by the government,” said Nora.
Recovery is possible
Addiction becomes an entire life issue and impacts many people. “It’s not just removing the substance from their life,” said Kate.
Abstinence is the most successful treatment but that doesn’t have to be the initial goal. “We talk about harm reduction,” said Kate. “We talk about Narcan, methadone treatment, embracing clean and sober time. We set realistic goals for people with addictions.”
Once addictions are being managed, people can get on with their lives, said Nora. “It’s pretty remarkable. Obviously their quality of life is much better.”
SMART Recovery self-management and addiction recovery training support group meets at the hospital every Friday afternoon from 2:30 to 4 pm.
Dr. Maguire would like to see an early recovery program established in Powell River. A Monday to Friday, 9 am to 12 pm program that would help people deal with all the things that trigger relapses.
“We need a program with a solid network that accepts that opiate substitution therapy (such as methadone or suboxone) is part of some people’s recovery maintenance.”