COVID AND ADDICTIONS IN RURAL ALBERTA

BY KRISTIN BAKER

THE COVID-19 PANDEMIC HAS BEEN WITH US FOR WELL OVER A YEAR NOW. IT HAS BEEN A TIME IN WHICH ALBERTANS HAVE FACED A RANGE OF UNCERTAINTIES AND CHALLENGES. ALONG WITH THE WORRY OF CONTRACTING THE VIRUS CAME OTHER CONCERNS, SUCH AS SERVICE DISRUPTIONS AND DECREASED TIME WITH FRIENDS AND FAMILY. MANY FACED SIGNIFICANT LOSSES SUCH AS THAT OF A JOB, A BUSINESS, OR A LOVED ONE.

FOR THOSE WHO WERE ALREADY LIVING with mental health or substance use disorders, the pandemic only increased difficulties. This is especially so for people living in the province’s rural areas, where COVID-19 heightened isolation and amplified an existing shortage of supports.

“Finding access to treatment that could be successful for those individuals has been quite a challenge,” says Diane Gillan, RSW. “It always was a challenge but COVID has made it bigger.”

Gillan recently worked as a post diagnostic outreach worker at Lakeland Centre for Fetal Alcohol Spectrum Disorder in Cold Lake (she left the position at the end of 2020). In the first 10 months of the pandemic, she saw a marked upswing in substance use amongst clients as well as in other community members. She believes several factors may have played a part in people’s increased use, such as the extra funds available through the Canada Emergency Response Benefit (CERB), loneliness, and reduced access to services.

“I think it was the isolation and the fact that there weren’t as many agencies available to support them and check in on them as there would have been normally,” she says.

COVID-19 also complicated the implementation of treatment plans for clients. Even something as simple as transporting a client to a recovery centre became impossible, especially to a facility located far from the Cold Lake area.

“The pandemic has added another layer of challenge. In the past you could set up those connections so that when the bus arrives, someone will pick you up [to take you directly to a designated recovery facility]. Without the ability to make those connections now, it’s pretty tricky.”

Some facilities near Cold Lake have strict detox requirements or medication rules; this makes it difficult for a number of clients to obtain a treatment bed in the area. Gillan used to be able to refer some of those clients to a Saskatchewan-based rehabilitation centre, but during the pandemic, health regulations restricted out-of-province patients. Since there is often a sense of urgency from clients when they decide to access treatment, these extra Diane Gillan obstacles affected some clients’ ability to pursue help.

“We tried really hard to constantly think outside of the box and come up with ways that would allow a client to get access to services. But sometimes all you can do is a regular check-in, so they know you’re available if something goes sideways.”

Gillan is also on the board of the John Howard Society in Cold Lake. In early 2021, they were able to open a new men’s shelter and hire a part-time outreach worker. “That has helped for people on the street that have nobody and nowhere to go. It helps those that are falling through the cracks with access to services in the system and setting up appointments.”

Emmy Kuypers, MSW, RSW, is the clinical director at Thorpe Recovery Centre, a detox and residential treatment program in Lloydminster. She also saw an increase in substance use and relapse amongst clients, especially after the first wave of COVID-19 when people were unable to leave their homes.

“Clients identified the time when things first got shut down as the point where they stopped going out and stopped seeing their support groups,” she says. “The idea of attending them online wasn’t set up yet, and by the time it was, they’d already started isolating again, which is a big red flag for relapse.”

She says that quarantine, sometimes paired with the stress of job loss, created a negative situation for many clients. Going to work (or their partner leaving the home to go to work) might once have provided a regular reprieve from substance use. That break was now missing.

“When people with addictions are forced to be at home alone or in unhealthy, toxic situations 24 hours a day with nowhere else to go, that kind of compounds and exacerbates the situations,” she says.

Reduced access to doctors or the cancellation of counselling appointments also intensified the issues. Added to that was the temporary closure of most of Lloydminster’s non-government funded social services.

“A lot of recovery supports are built around connections and attending groups, and all of a sudden, the world shut down,” she says. “The majority of my clients who came in during that period said the isolation of COVID-19 and being alone, not going to meetings, that was a big push for relapse.”

The pandemic also created challenges for Thorpe Recovery Centre staff. In early 2020, the facility expanded from 24 beds to 72 beds. Pandemic health orders required them to quickly re-evaluate the design and delivery of programming while ensuring the needs of residents were still met.

The staff and social workers adapted in ways that amazed Kuypers. They increased outdoor programming, created smaller groups to allow for distancing, and invited community agencies to make online presentations to the residents.

“I’ve seen a resilience and a way of accepting that’s extraordinary. There’s also compassion for clients – about how hard this must be for them as well.”

Kuypers says that for people with addictions, connections to services such as counsellors and support groups are important to ongoing recovery; these need to be set up before a client leaves the facility. This has changed now given the altered service landscape.

“We’ve partnered with a lot of agencies to provide even more programming than before, but it’s just a different format,” she says. “We’re getting clients on board with access to services looking different and showing them that the digital version or a phone call is still a bonus.”

Kanakii Mekaisto, MEd, BSW, RSW, is a teacher and knowledge keeper in Siksika Nation. She says the pandemic has had a huge impact on Siksika residents already living with mental health issues and substance dependencies. It has also contributed to social disorder and more people trying drugs.

“Because of COVID-19, there is a really high rate of addiction and suicide. Our people, because they have nothing to do, they try [meth] once, then they get hooked,” she says. “And also due to mental health issues, we have high rates of criminal activity.”

Siksika Nation is located 126 kilometres east of Calgary. An existing lack of services in the area combined with pandemic closures and restrictions has led to isolation and a shortage of things to do. On top of this, many of the community’s traditional ceremonies have been modified or cancelled. This affects the healing that in-person connection and support can provide.

“Kids and young people don’t have anywhere to go and people can’t even get a ride anymore because of COVID19,” she explains. “A huge part of this is kids in care; they can’t even visit their family because of COVID-19’s effects.”

Mekaisto notes that due to past experiences and trauma, many people in Siksika feel ashamed to admit they have a problem or to ask for help. Even if they do reach out, limited access to substance dependency and mental health assistance is an ongoing frustration for residents. Though the community has an addictions support group, generally people must go off reserve to obtain services.

“The mental health workers come and go, and people don’t want to go see them because they think they could be gone tomorrow. They don’t help our people with learning traditional knowledge and the therapy and healing that comes from our ways.”

Mekaisto cites several factors that have contributed to – and continue to affect – Siksika peoples’ ongoing mental health and dependencies. These include intergenerational trauma resulting from residential schools; racism; past and present governmental decisions; regulation issues; authority figures’ unwillingness to understand underlying causes; and inadequate traditional teachings. The pandemic has only added more issues to those already faced by the community.

Mekaisto says that for Siksika residents to begin healing from pre- and post- pandemic issues, there needs to be an investment in educating Siksika people – especially its youth – in the traditional ways.

“Our real traditional knowledge people have empathy and are the ones that are helping people and connecting with people. If they had more of that, people would feel more safe asking for help.”

She explains that outsiders are often brought in to aid the Siksika community. It should instead be Siksika elders and knowledge keepers who provide this help to residents – and they should be compensated for their teachings.

“They don’t get any support, but they’re the ones who should be getting paid the most. They already have relationships with people, people know them and that they live a life of care and compassion,” she says. “People can go to them and feel good and safe. If they had more of that, they’d be able to flourish.”

COVID-19 has obviously presented additional challenges to those already facing addiction and mental health issues in Alberta’s less-populated areas. But there’s hope for the post-COVID-19 world.

“I always try to have hope,” says Gillan. “But I think it’s going to take a bigger effort to give access to services to those who can’t advocate for themselves very well.”

Kuypers is optimistic that because Albertans didn’t see each other in person very much during the pandemic, they’ll recognize how important that is going forward.

“I’m hoping that once things are different, that because of the way we’ve been living for so long, people will really embrace connections and supports.”