May 2nd, 2018 ~ Vol. 89 No. 18
Harm reduction and opioid education information session
Crowsnest Pass Herald Front Page
Pass Herald Reporter
Addiction can manifest in many different ways: gambling, alcohol, cigarettes, food, drugs. While each adversely affects the individual and places a heavy burden on the health care system, we generally have a much different perception about one of these addictions that the rest, and that's drug use.

"People need to self-examine the way that they look at drug use because addictions exist whether it's food, cigarettes, online shopping or sex. Those things cost our healthcare system too, particularly with obesity and cancer related to smoking. With those folks, we as a society look at them and say, 'That's a bad choice', but we don't look at them and say, 'That's a bad person'. We do that with drug users," says Jill Manning, the managing director at ARCHES in Lethbridge.

Manning spoke at an information session held at the Crowsnest Community Library on April 24 about drug use, the opioid crisis and safe injection. The purpose of the event was aimed at dispelling the stigma around drug use through education and information and teach participants how to use a take-home-naloxone (THN) kit which has the potential to save a life during an overdose.
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The information session was an effort spearheaded by Licensed Practical Nurse (LPN) Alex Oczkowski at the Crowsnest Medical Clinic after she noticed a higher level of blood borne illnesses in fall 2017 attributed to shared use of intravenous drug supplies. She reached out to ARCHES to see if they can offer any support.

"There was a need from people who use drugs in our community for clean injection and inhalation supplies for drugs. I also noticed a need when more people were being diagnosed with blood borne illnesses in the community," says Oczkowski.

Using non-sterile equipment poses a danger to the user, including risk of contracting Hepatitis C, HIV and bacterial infections.

Present at the information session were also Dr. Stephen Annand from the Crowsnest Medical Clinic and Loretta Shaufele, a local addictions specialist.

Following a group training session on how to administer naloxone, THN kits were distributed to willing participants. Naloxone can temporarily reverse the effects of an overdose before medical attention arrives, but does not replace medical attention.

"Naloxone is a drug that has been used within pharmacy, EMS and hospitals for years in order to reduce the effects of an opioid overdose. Until about three years ago, they weren't available to the public because there was no need for them, but once the opioid crisis hit and we saw overdose fatalities skyrocket, Alberta Health decided to make those free and available to the public," says Manning.
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In another harm reduction strategy, Lethbridge ARCHES started providing safe injection kits, both for injection and inhalation, to the Crowsnest Medical Clinic in January 2018. The kits contain sterile supplies for everything a person would need to safely inject: syringes, cookers (used to heat up injectable drugs), tourniquets, alcohol swabs, citric acid or vitamin C (used to make the drug more soluble) and sterile water packets

A big part of the workshop was an effort to destigmatize drug use and people who use drugs, a topic near and dear to Oczkowski.

"We associate people of the lower social economic class as being the ones who use drugs and a lot of times, we consider those people bad people. There's a lot of shame and judgement towards the homeless and the street-involved people that use illicit drugs and I don't think that people realize that there are other people who use drugs, too. Hearing the stories from people and how they go to the place they're in is so interesting and it really makes you realize that with just a couple of life changes, and any of us could be in their situation," she says. "Lots of times, people who have drug addiction are treated differently than those who access the healthcare system for a physical need. I want to make them feel like they're given the treatment that they deserve and make them feel more comfortable in the healthcare system because historically, I think they were treated poorly."
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Manning adds that the opioid crisis is different from other drug epidemics because it affects all populations across all age, sex and social status groups.

"Anyone might have a friend or family member who might be using drugs, and you may or may not even know it. It's not just a homeless or street-involved issue," she says. "We really educate the public around the fact that it could be anyone and that traditional detox and treatment programs, they don't work for opioid users. There’s about a three percent success rate for people who have opioid additions who go through traditional treatment programs.”

According to data collected by Alberta Health, an average of 1.9 people die per day from apparent accidental opioid overdose. In 2017, 687 people died from an accidental opioid overdose, where 562 people died from an apparent accidental overdose specifically as a result of fentanyl. This is compared to 358 people in 2016. Over 80 percent of deaths from accidental fentanyl overdose occurred in urban centres.
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Data reflecting the opioid situation in Crowsnest Pass specifically is not available through Alberta Health data collection. Crowsnest Pass makes up the "south zone" of data collection, encompassing the area south of Calgary. This means that data applicable to Crowsnest Pass is grouped with data coming from urban centres like Lethbridge and Medicine Hat, where opioid use is considerable more prevalent.

While opioid use is not as high in Crowsnest Pass as it is in urban centres or other nearby communities within the south zone, Oczkowski says fentanyl is still present. Fentanyl, a synthetic opioid, is different from other drugs in that it is much more potent than traditional drugs. For example, it is 50 to 100 times more potent than morphine.

"There is no doubt that some of the drugs that people are using are either cut with fentanyl or they are using fentanyl," she says. "I don't think that Crowsnest Pass has seen the full extent as, say, the Blood Reserve or Lethbridge has."

Take-home-naloxone kits are available for free at the Crowsnest Medical Clinic, local pharmacies and ARCHES locations. The supplier of these kits is Alberta Health Services. Kits can be obtained anonymously but require a 15- to 20-minute lesson on how to use the kit and how to store it.

Sterile injection and inhalation kits are available at the Crowsnest Medical Clinic for free as well. Kits are given out confidentially and no personal information is required to obtain one. The clinic also supplies disposal containers and accepts sharps containers that are full.
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May 2nd, 2018 ~ Vol. 89 No. 18
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