Special Features - Overdose Prevention - 2019 Resource Guide

Opioids: What you need to know

Overdose Prevention n n n

n

GREATER VICTORIA

2019 RESOURCE GUIDE

What are opioids?

Know the risks Avoiding overdose Getting help

COMMUNITY PARTNERS

PLUS… • Who to call • How to help • Teens & seniors

A COMMUNITY COMING TOGETHER FOR VICTORIA’S OPIOID EPIDEMIC

You don’t need a referral and most therapies are covered for residents of BC. There are medications that reduce or eliminate cravings. Visit your doctor or a care provider to explore treatment options. For more information, visit: islandhealth.ca/oat

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OVERDOSE PREVENTION RESOURCE GUIDE

SPECIAL REPORT: OVERDOSE PREVENTION

Cynthia Smith, Camosun College, Sandra Richardson, The Victoria Foundation, Ruby Della Siega, Monday Magazine, Mark Breslauer, United Way Greater Victoria.

‘Who is affected? We all are.’

At Camosun College, applied learning, interdisciplinary collaboration and community partnerships are at the heart of everything we do.

As our region tackles a public health crisis related to drugs and overdoses, accurate and freely accessible information, and a holistic approach involving health care practitioners, educators, the media, all levels of government and community partners is required now more than ever.

Camosun students in the health and human services disciplines are learning strategies to address this serious health issue.

Camosun is pleased to support the publication of the Overdose Prevention Resource Guide because education is essential to people getting the help they need and working towards solving the complex societal problems related to drug abuse and addictions.

We’re all in this together and good education is the best hope for long-term, sustainable, and systemic change.

Cynthia Smith, Dean of Health and Human Services, Camosun College

Since its inception in 1936, The Victoria Foundation has had a vision to strengthen the community and increase quality of life for residents.

For many, the opioid crisis facing the Capital Region, and indeed BC as a whole, has put that quality of life at risk.

Who is affected? We all are.

Those at risk of overdose are mothers and grandfathers, sons, daughters and sisters. They come from all backgrounds and walks of life – students, tradespeople and professionals alike.

This crisis affects not only those at risk of overdose, but their families, friends and co-workers, first responders and those hard at work in the social service sector.

As a community-wide challenge, solutions will likewise involve the entire community.

In the annual Vital Signs report, we explore the diverse issues facing our region, in turn helping donors choose where their funds can make a real difference.

Our mandate at the Victoria Foundation is to connect people who care with causes that matter.

For many people within our community, few causes are resonating as deeply as this one.

The Saunders Family Foundation has been operating for just over nine years but our family, with many others, has supported families in need and community initiatives for decades.

When Black Press approached us to become involved in their Overdose Prevention Resource Guide, our family, through our experience helping families, welcomed the idea and congratulates Black Press for spearheading the outreach.

The tragic opioid/drug epidemic affects not only individuals but the community as a whole.

We do not think we are alone when saying the possible loss of a loved one – a mother, a father, a young adult, child or in some cases, an unborn baby – for whatever reason, just can not continue to happen.

We sincerely hope this resource guide helps raise the awareness needed for those people searching for answers and help guide those struggling with the effects of addiction.

Our heartfelt condolences to those who have lost and most importantly to those who continue to struggle.

Thank you to all who are helping with this Overdose and Prevention Resource Guide.

In 2018, 1,510 people died from a drug overdose in BC. Victoria is the third highest in the number of deaths due to overdoses amongst communities in our province. This is a public health crisis affecting all of us.

How can we change this?

For 82 years, United Way Greater Victoria has been at the forefront of challenges impacting the community.

We work collaboratively to respond to long-term social issues and to emerging needs such as the opioid crisis.

That’s why we are working within the community to tackle this critical issue through education and outreach, by helping those who are using opioids and those who are supporting loved ones who are using. In addition to programs and services we currently fund to help people change their lives for the better, we are developing overdose and drug literacy workshops to reach different audiences including middle and high-school students.

We are proud to sponsor Black Press’ resource guide and host our Overdose Prevention Expo from 11am to 2pm May 8, 2019, at The Bay Centre downtown.

To the extent we can help prevent harm and offer support through education and resources, our efforts are worth it.

Sandra Richardson, CEO, Victoria Foundation

The Saunders Family, The Saunders Family Foundation

Mark Breslauer, CEO United Way Greater Victoria

OVERDOSE PREVENTION RESOURCE GUIDE

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Opioid crisis

BY THE NUMBERS: n 1,510 people died of drug overdoses in B.C. in 2018, including 237 on Vancouver Island n 83% of the people who died from drug overdoses were men n 88% of deaths occur indoors n 76% of those who died were aged 30 to 59 n 0 deaths at supervised consumption and overdose prevention sites n 1,045 Take Home Naloxone Kits were distributed in November 2018 n 226 active prescribers of Opioid Agonist Therapy by end of December 2018

What’s inside Supervised Consumption Sites .......................5 Opioids & fentanyl...........................................6 Tips to prevent overdose.................................7 Naloxone: what you need to know ................8 Overdose epidemic: Who’s really affected.....12 OAT: Opioid Agonist Therapy ........................14 Talking with your teen about drugs...............16 Where to get help.........................................18 How to respond to opioid overdose .............20 Substance use in older adults .......................22 Prevention services on the West Shore..........24 Language matters: fighting stigma...............26 PhotoVoices Project.......................................27 Help for families.............................................29 Harm reduction: what it is, how it works......31 Safe disposal of medications & needles.........33 Resource guide..............................................35

There were over

1500

suspected overdose deaths in British Columbia last year.

Don’t let someone you love become another statistic.

we can help stop the cycle ~ 1-800-683-0111  Supportive residential treatment  24/7 medical team  Trauma specific programs  Withdrawal management  Evidence-based therapies  Safe, therapeutic environment  Outpatient programs  Ongoing support and aftercare groups  Financing available 4

OVERDOSE PREVENTION RESOURCE GUIDE

Working collaboratively with our community partners to combat this current crisis is critical. We must break the cycle and save lives.

Contact us today and we will help you find the type of treatment that’s right for you.

EDGEWOOD EHN CANADA

OVERDOSE PREVENTION SUPERVISED CONSUMPTION

Supervised consumption is key to overdose prevention Island Health has seen more than 250,000 visits across its nine supervised consumption and overdose prevention sites on Vancouver Island since the first opened in December 2016. During the same time, staff reported more than 1,000 reversed overdoses, but zero deaths.

Staff have also delivered additional supports and services to people who are using drugs and for people who are ready to begin a recovery journey, Island Health reported in March 2019.

“Observed consumption services are more than just overdose prevention – these are the beginnings of a supportive community,” said Dr. Richard Stanwick, Island Health Chief Medical Health Officer. “And the staff and peers working at these locations play a vital role in addressing stigma and supporting people who are the most vulnerable.”

Overdose prevention and supervised consumption services help people reduce their risk of overdose by using drugs under the supervision of trained staff, who also offer harm reduction supplies, peer support, public health nursing, mental health and substance use supports and linkages and referrals to treatment.

“Overdose prevention and supervised consumption services are a critical part of our response to the

The Harbour in Victoria.

overdose crisis,” said Judy Darcy, Minister of Mental Health and Addictions.

“These services not only save lives but also connect people to treatment and recovery options and other supports to help them make safer choices and find a pathway to healing and a pathway to hope.”

In addition to Victoria’s locations, additional Island Health locations are found in Campbell River, Courtenay, Duncan, Nanaimo and Port Alberni.

An average of 3,250 visits are made every week to these sites.

Island Health photo

“Observed consumption services are more than just overdose prevention – these are the beginnings of a supportive community.”

Victoria Overdose PREVENTION SITES GREATER VICTORIA CURRENTLY HAS FOUR OVERDOSE PREVENTION and rapid overdose response, 713 Johnson St., 250-889-0268, OR SUPERVISED CONSUMPTION LOCATIONS: avi.org.

Harbour (formerly known as Pandora Supervised Johnson Street Community – Note: This site is open 1 The Consumption Centre) – 10 consumption booths, post-use 3 to building residents only, 844 Johnson St., 250-812-1764, areas, rooms for counselling, medical help, naloxone kits, education and support, 941 Pandora Ave., 250-519-5303.

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AIDS Vancouver Island – Harm reduction services, including an overdose prevention room for safer drug use

phs.ca/project/johnson-street-community

Cool Aid Society – Services include a variety 4 Victoria of harm reduction services and supports, 535 Ellice St., 250-383-1951 ext. 2247, coolaid.org.

OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION Opioids: What they are + how they work Opioids are a type of depressant that slows the body’s systems, including breathing, and can make people sleepy. They can be prescribed by a physician or used illegally.

Opioids can be swallowed, injected, absorbed through the skin or inhaled or smoked, and are used to reduce pain, manage opioid dependence, or to make someone feel happy or relaxed. Common opioids include heroin, fentanyl, morphine, methadone, codeine and oxycodone.

ABOUT ADDICTION

What is fentanyl?

An extremely potent opioid pain reliever, fentanyl is generally administered in a hospital via skin patch, injection or tablet, or prescribed by a doctor, to help control severe pain.

What makes fentanyl so dangerous?

A cheap way for drug dealers to make we’re seeing high rates of overdoses and street drugs more powerful, illegal fentanyl related deaths. and fentanyl-like drugs such as carfentanil Illicit fentanyl is manufactured in clanare contaminating Canada’s illegal destine drug labs, overseas and in Canadrug supply. da. It may be cut into powders or At 20 to 40 times more pressed into pills, says the BC potent than heroin and Centre of Disease Control 100 times more potent website, Toward the Heart. than morphine, the risk Fentanyl is sometimes • call 9-1-1 immediately sold as fentanyl but other ilof accidental overdose is very high, especiallegal drugs can also contain • provide rescue breathing (mouth-to-mouth) ly when street drugs it, including heroin, cocaine, can contain unknown oxycodone, crack or meth.

• administer naloxone amounts of fentanyl. It can It may be in powder, liquid be mixed with drugs, and is or pill-form drugs. These may found in counterfeit pills made contain toxic contaminants or have different levels of fentanyl in each batch. to look like prescription opioids.

Even pills produced in the same batch may You can’t see, taste or smell it and a have little to lethal levels of fentanyl. few grains can be enough to kill you – why

Overdose: What to do:

OVERDOSE PREVENTION PROJECT Dreanna is 22. She has been clean for 4 years.

She figures that if she hadn’t stopped using, she would be dead today.

Last year in BC, 1,510 people died of a drug overdose: 87% of illicit drug overdose deaths involved fentanyl.

For more than 80 years, United Way has been tackling unignorable issues impacting our community like the opioid public health emergency.

Give to United Way and help save lives.

Visit: uwgv.ca/overdoseprevention Overdose Prevention Project #unignorable supported by

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OVERDOSE PREVENTION RESOURCE GUIDE

See Dreanna’s full story on page 11

OVERDOSE PREVENTION

KNOW THE RISKS

Overdose is most common when: n Your tolerance is lower: you took a break, were in detox/ treatment or jail, or you are new to use n You have been sick, tired, run down, dehydrated or have liver issues n You mix drugs: prescribed or not, legal or illegal n The drugs are stronger than you are used to: changes in supply, dealer, or town

What an opioid overdose looks like: n Person cannot stay awake n Can’t talk or walk n Slow or no pulse n Slow or no breathing, gurgling n Skin looks pale or blue, feels cold n Pupils are tiny or eyes rolled back n Vomiting n Body is limp n No response to noise or knuckles being rubbed hard on the breast bone

TIPS TO PREVENT OVERDOSE n Know your health status and your tolerance. n If using, take one substance at a time (don’t mix with alcohol). n Use with friends. If you use alone, leave the door unlocked and tell someone to check on you. n Be aware: using drugs while on prescribed medications can increase overdose risk. n Do testers to check strength. Use less. Pace yourself. n Talk to an experienced person or a trusted healthcare provider about reducing risk. n Know rescue breathing and carry a naloxone kit.

Choose a safer route of taking drugs SAFER / NO USE

SWALLOWED

SNORTED / SMOKED / INSERTED

INJECTED

MORE LIKELY TO OVERDOSE

From Toward the Heart/towardtheheart.com OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

NALOXONE

What is naloxone?

Naloxone is a medication that reverses the effects of an overdose from opioids, such as heroin and fentanyl.

It is available in BC without a prescription.

Naloxone: What you need to know to save a life What do we mean by opioid overdose?

An overdose happens when the body is exposed to a toxic amount of a substance or combination of substances, and it can happen to anyone, regardless of substance use history, explains Toward the Heart in its Naloxone Administration course (towardtheheart.com).

In response, the body cannot maintain the processes necessary for life, such as breathing, heart rate or body temperature.

Someone experiencing an opioid overdose might exhibit slow, shallow irregular or no breathing, for example, may be unresponsive – you’re unable to wake them up – they may make unusual gurgling, snoring or choking sounds, and they may have blue lips or nails, cold, clammy skin and tiny pupils.

While an overdose isn’t necessarily fatal, without quick treatment, brain damage can result.

Naloxone is the drug used to counteract the effects of an opioid overdose and it’s available in BC without a prescription.

Naloxone temporarily reverses life-threatening slowed breathing that accompanies an opioid overdose. While it doesn’t work with non-opioid drugs, such as cocaine or ecstasy, it won’t hurt the individual if they haven’t used an opioid. And if multiple substances have been used, administering naloxone will address the opioid.

To administer naloxone, it can be injected into a large muscle, such as a thigh, upper arm or buttock, or given as a nasal spray.

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OVERDOSE PREVENTION RESOURCE GUIDE

While naloxone works quickly – within three to five minutes – it stops working within 20 to 90 minutes and if overdose symptoms return, additional doses may be required.

Naloxone kits Naloxone kits are available at no cost to people at risk of an opioid overdose or those likely to witness or respond to an overdose – such as the friends or family of someone at risk.

Kits are also available for purchase from pharmacies, where pharmacists can instruct you how to administer it.

Included in the kits are instructions about responding to someone who is overdosing, naloxone and syringes to administer it, alcohol wipes, gloves, disposable breathing mask.

Learn more: If you’d like to learn more about naloxone and how to administer it in case of an overdose, Toward the Heart offers both a free online course and a video.

The course, which takes just 15 to 20 minutes to complete, walks you through both background information and the administration of naloxone, including several instructive videos.

Take the free, online course at towardtheheart.com/ naloxone-course • Learn more about overdose prevention at towardtheheart.com • For more information on overdose awareness in B.C., visit stopoverdose.gov.bc.ca.

ADDIC TION TRE ATMENT SERVICES

Cedars at Cobble Hill is a residential addiction treatment center offering the serenity, hope and healing that individuals need to embark on their journey of recovery. Situated on over 65 acres of property with several kilometers of trails, our environment provides patients with privacy in a natural therapeutic setting.

Cedars treats the full spectrum of substance use disorders as well as disordered eating, compulsive gambling and compulsive sexual behaviours. Our team of licensed counselors, addiction medicine physicians, nurses and support staff all play an equal part in supporting our clients and their recovery.

From our accommodation to our staff we offer the most accessible patient support.

CEDAR S FAMILY PROGR AM Learn to cope with your loved one’s addiction Discovery is meant to bring positive change. Often times, we believe that we are alone in our struggles.

Discovery grants families the opportunity to heal, accept, and grow both individually and as a unit.

Throughout this program, participants will embark on a journey of recognition through an association with like-minded individuals.

If you have a close relationship with someone who has a substance use disorder, the Discovery Program is designed to assist you with coping mechanisms to relieve the stress of addiction and related circumstances. Explore this therapeutic experience and psychoeducational program inviting you to delve into topics such as connection, communication skills, self-acceptance, and support.

A full recovery is possible - for the whole family

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discovery@cedarscobblehill.com www.cedarsdiscovery.com

OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

Where can I find NALOXONE? Take-home naloxone kits are available at no cost to: • people at risk of an opioid overdose • people likely to witness and respond to an overdose such as a family or friend of someone at risk UVIC Student Health Services 3800 Finnerty Rd., 250-721-8492 uvic.ca/services/health Saanich Health Unit 3995 Quadra St., 250-519-5100 islandhealth.ca Royal Jubilee Hospital 1952 Bay St. islandhealth.ca Outreach Services Clinic 603 Gorge Rd. E., 250-480-1232 outreachservicesclinic.com Victoria Sobering Assessment Centre 1125 Pembroke St., 250-213-4441 islandhealth.ca South Island Communicable Disease 1947 Cook St., islandhealth.ca Threshold Housing Society 1524 Fort St., 250-383-8830 thresholdhousing.ca Pandora Clinic 922 Pandora Ave., 250-294-6714 pandoraclinic.com

Save-On-Foods (Fort & Foul Bay) 1950 Foul Bay Rd. Save-On-Foods (Saanich), 3510 Blanshard St. Save-On-Foods (Tillicum Mall) 3170 Tillicum Rd.

Pandora ACT Team 941 Pandora Ave., islandhealth.ca

Save-On-Foods (Westside Village) 100 - 172 Wilson St.

Our Place Society 919 Pandora Ave., 250-388-7112 ourplacesociety.com

London Drugs (Saanich Centre) 127 - 3995 Quadra St.

Alert First Aid A – 920 Johnson St., 250-595-5323 alertfirstaid.com Johnson Street Community 844 Johnson St., 250-812-1592 phs.ca SOLID 1139 Yates St., 250-298-9497 solidvictoria.org Peninsula Health Unit 2170 Mount Newton Cross Rd., Saanichton, 250-544-2400 PHARMACIES Save-On-Foods (University Heights) 3958 Shelbourne St.

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London Drugs (Tillicum Centre) Y003A - 3170 Tillicum Rd. London Drugs (Yates St.) 201 - 911 Yates St. London Drugs (Colwood) 1907 Sooke Rd. Pharmasave (Broadmead) 310-777 Royal Oak Dr., 250-727-3505 Pharmasave (James Bay) 113 - 230 Menzies St, 250-383-7196 Shoppers Drug Mart (Uptown) 3511 Blanshard St., 250-475-7572.

Shoppers Drug Mart (Royal Oak) 100 - 4440 West Saanich Rd., 250-881-1980 Shoppers Drug Mart (Hillside Centre)

1644 Hillside Ave, 250-595-5111 Shoppers Drug Mart (Fort St.) 1627 Fort St., 250-592-4541 Shoppers Drug Mart (Gorge Centre) 2947 Tillicum Rd., 250-383-7702.

Shoppers Drug Mart (Douglas St.) 1222 Douglas St. Shoppers Drug Mart (Esquimalt) 870 Esquimalt Rd., 250-361-2011 Estevan Pharmacy 2517 Estevan Ave. UVic Campus Pharmacy SUB B13 - 3800 Finnerty Rd, 250-721-3400 Richmond Pharmacy 102 - 2020 Richmond Rd. Fort Royal Pharmacy 1912 Richmond Rd. Aaronson’s Pharmacy 1711 Cook St., 250-383-6511 STS Pain Pharmacy 820 Cormorant St. LalliCare Clinic 1139 Yates St., 250-386-5100 Victoria Compounding Pharmacy 1089 Fort St., 250-388-5181

OVERDOSE PREVENTION

UNITED WAY

Walking in Dreanna’s shoes Dreanna has been clean for four years now. She’s 22. She figures that if she were still using, she’d be dead.

Dreanna started struggling with mental health issues when she was about 10 years old. She was scared to tell her parents about her struggles. “I was so lost. I was just a kid.

“When drugs came in, I was about 13 ... I thought I’d found the solution. I thought the struggles with mental health, depression, anxiety, suicidal ideations, off of that stuff, I thought I’d found a cure for it through drugs.”

Things got “ugly” fast. She was expelled from school. Left home.

“I know that if I didn’t get clean when I did, you know I was heading down a road where I wasn’t saying no to anything. I didn’t care.”

Dreanna attributes a United Way-funded agency in Victoria, the Foundry, to saving her life.

She went down the path of recovery, through detox and counselling. Now Dreanna helps others struggling with addictions and mental health issues and helps youth by sharing her story.

Her goal is to get her Masters in Social Work, specializing in Addictions and Mental Health.

“I hold compassion because I know people are hurting.”

Her advice to young people who are struggling? “Surround yourself. Don’t be alone. If you can make it through 15 minutes, you can make it through.

Stay in your shoes.”

For 82 years, United Way Greater Victoria (UWGV) has been tackling complex social issues facing the region. UWGV funds a continuum of programs and services to help people in need.

Through de-stigmatization, education, compassion and factbased information, UWGV along with a strong network of community partners, is caring for the community and promoting strategies and initiatives to manage harm reduction and ultimately, to save lives.

For more information, visit uwgv.ca

OPENING MAY 22, 2019 Homewood Ravensview provides immediate, expert treatment for clients living with mental health, addiction and concurrent conditions.

Delivering evidence-based, medically-led treatment, Homewood Ravensview is the first and only facility in Western Canada offering private inpatient mental health services.

RAVENSVIEW.COM

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OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

Opioid epidemic: Who is really affected?

Who is affected by the current opioid overdose epidemic?

Dr. Richard Stanwick, Island Health Chief Medical Health Officer, answers quickly: “The answer is everyone.”

“This affects everyone, from the health care professionals to the more typical people thought of as the street entrenched,” Dr. Stanwick says.

And everyone in between.

For example, the picture of the region’s overdose deaths typically occurring among those living on the street isn’t accurate.

In fact, 88 per cent of deaths occur indoors and 76 per cent of those who died were aged 30 to 59. Many died alone, pointing to the importance of harm reduction measures, inlcuding the recommendation that individuals who are going to use, not use alone. (See page 5). It’s also noted that no overdose deaths happened at a harm-reduction site.

Many overdoses involve individuals who are employed, with the trades and transportation industries among the most common represented.

In some cases, prescription opioid dependency emerges from work injuries; in other cases, disposable income and recreational drug use can either grow into a dependence, or can lead to an accidental overdose when other drugs are laced with more lethal drugs, such as fentanyl.

Those who are found to be using while on the job often do so to reduce symptoms of withdrawal, which can include severe flu-like symptoms, or to mask pain, not to get high, Dr. Stanwick notes.

Others, such as older people who might have developed a dependency following surgery, for example, but who can no longer access prescription medications, can turn to suicide.

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Among the Indigenous community, it’s estimated the impact is three to five-times higher than the general population, Dr. Stanwick says, noting Island Health works closely with the First Nations Health Authority to support those communities.

A provincial health emergency Because testing has shown fentanyl to be present in so many illicit drugs in BC, typically finding its way into the province via drug producers in China, recreational users are also at risk.

University students may believe their source of Ecstasy, for example, is trustworthy, only to fall victim to unintentional consumption of fentanyl.

The impact of the opioid crisis – declared a provincial health emergency in 2016 – “has forced us to recognize the dependency on opioids,” Dr. Stanwick says. “It’s forced us to rip off the bandage, so to speak, and recognize

the lethality of it.

“It’s also estimated that the crisis has actually driven down the life expectancy of the province by as much as a year,” Dr, Stanwick says.

And with people often dying in their most productive years, it also affects the province’s economy, all in addition to the various tolls on the health care system, from the financial drain to the burnout among health care workers and first responders.

Even for those who benefit from live-saving naloxone, the life-long impacts of the crisis can continue to be felt, whether from the long-term effects of addiction or brain damage that can come from non-fatal overdose.

“We have to look at the dependency as a medical term that reflects the human brain and as with all dependency we should treat that from a health perspective.”

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OVERDOSE PREVENTION

OAT: Effective treatment for opioid addiction Opioid Agonist Therapy – or OAT – has been effectively used to treat opioid addiction for decades, but today, more options are available to individuals seeking an effective treatment for addiction to opioid drugs such as heroin, oxycodone, fentanyl and Percocet.

Patients take medications such as Methadone, buprenorphine (Suboxone) or Kadian to prevent withdrawal and reduce cravings for opioid drugs.

Not only do the medications reduce risk for overdose and other dangers associated with using opioids, but they also reduce risk for relapse and promote connections with health and substance use services.

“The best way to reduce the risk of overdose if you have opioid addiction is to be on one of these treatments,” says Island Health’s Dr. Ramm Hering.

Dr. Hering estimates there are approximately 1,200 people in the Greater Victoria on OAT treatment – while three times as many people locally could likely benefit.

How Opioid Agonist therapy works: “Very quickly after starting to use opioids, you become physically dependent,” Dr. Hering says.

Biology plays a big role in this process as people suffering from opioid addiction have brain changes that play large part in people continuing to use.

Once that happens, anywhere from an hour to six hours after using, a person will start feeling flu-like symptoms of withdrawal.

With OAT, the long-acting opioid medications keep people out of physical withdrawal for 24 hours, “so they can get on with their normal life,” Dr. Hering explains. “It helps stabilize the person, giving them the space they need to work on the other challenges such as physical and mental health 14 OVERDOSE PREVENTION RESOURCE GUIDE

concerns, housing and financial instability and other personal challenges that are contributing to their harmful substance use.”

By acting slowly in the body, the therapy prevents withdrawal without causing a person to get high, Dr. Hering explains. OAT also helps to reduce or eliminate cravings for opioid drugs.

Treatment works best when combined with other types of support, like individual or group counselling.

Each of the three OAT treatments has its own pros and cons patients should discuss, and each person will tolerate the treatments differently.

Methodone, for example, has been used for more than 50 years.

Because there’s a higher risk of overdose, patients will go to their local pharmacy for their dose for at least

the first three months as they stabilize. The dose is gradually increased until they are symptom-free for the full 24-hours. Methodone can have significant interactions with other medications and be tolerated poorly by people with certain other medical conditions, so needs to be prescribed very carefully.

Suboxone is much less risky for overdose and patients who are stable can have their treatments at home quite quickly after starting, Dr. Hering says. However, it’s often challenging for patients to start as they typically need to be in moderate withdrawal to start it.

Kadian carries a higher risk, so patients typically continue to take it at the pharmacy through the course of treatment.

OVERDOSE PREVENTION Continued from previous page Methadone is taken as a drink, Kadian is a capsule with beads that is typically opened in the pharmacy and taken in apple sauce/pudding, while Suboxone is a tablet that’s dissolved under the tongue.

How to get treatment: You don’t need a referral for OAT treatment, and it can be discreetly prescribed by a physician or nurse practitioner. Simply contact your primary care provider, visit a walk-in clinic or contact a community OAT clinic to learn about treatment availability.

The Rapid Access Addiction Clinic (RAAC) on Pembrooke and Cook streets has walk-in availability Monday to Friday from 9 to 10am.

You can also ask your care provider if you qualify for free OAT treatment.

While any doctor can prescribe Suboxone, Methadone and Kadian are a little more specialized, Dr. Hering says.

How you’ll feel on OAT: When first starting treatment, you may feel lightheaded or sleepy for a few days, but will quickly develop a tolerance to these effects, explains Canada’s Centre for Addiction and Mental Health. OAT doesn’t provide the high, but it can help keep the physical cravings at bay.

While people take OAT for years without any ill effects, they are powerful drugs and can be extremely dangerous if taken by someone other than the intended patient, so never sell or give away any of your dose.

Children are particularly at risk – even a small amount can be fatal.

OAT TREATMENT slowly while simulataneously working to strengthen all other addiction supports.

While timelines will vary with each person, stopping OAT before you’re ready carries a high risk of relapse and of overdose. Continuing OAT over a longer term helps keep you safe, and allows you to work on some of those underlying factors that drew you into addiction, such as physical pain or emotional trauma.

“Part of recovery from addiction is learning how to tolerate distress,” Dr. Hering says.

Learn more at islandhealth.ca/oat or camh.ca.

Looking forward: How long will you need to use OAT? Typically treatment will last at least a year or two, and many people will stay on OAT for many years, Dr. Hering says.

If you do decide to stop OAT, it’s best to taper off the medication very

Supporting a loved one?

Symptoms of opioid withdrawal For those using an opioid, substitution therapy is typically better than trying to go into withdrawal alone, which often leads to relapse, Island Health notes.

During withdrawal from opioids, common – but temporary – symptoms include: Acute Withdrawal (first stage) • Heroin, morphine, oxycodone and hydromorphone – Symptoms appear 2 to 12 hours after the last dose, increase over the next three days and gradually disappear over 7 to 10 days.

• Methadone – Symptoms appear 24 to 48 hours after the last dose, increase over the next 3 to 6 days, and gradually disappear over 3 to 6 weeks.

• Fentanyl patch – Symptoms appear 8 to 24 hours after the last patch, increase over the next several days and gradually disappear over 1 to 2 weeks.

• Buprenorphine (the opioid in Suboxone): Symptoms appear 1 to 3 days after last dose, increase over the next

3 to 7 days after the last dose and may continue for 2 to 6 weeks.

• Codeine – Withdrawal is similar to morphine, but typically less intense.

Typical symptoms, by frequency, include: Physical symptoms • muscle, bone and joint pain, especially in the legs and lower back • sweating, alternating with chills and waves of goose bumps • loss of appetite, nausea, vomiting, stomach cramps, diarrhoea • restlessness, nervousness, weakness • muscle spasms and kicking movements • insomnia • fever, headache, flu-like feeling • rapid heart rate • runny eyes, runny nose, sneezing, yawning Psychological Symptoms • anxiety

“The most important thing in terms of family members is just understanding that addiction is an illness,” says Island Health’s Dr. Ramm Hering. “Very quickly when you become physically dependent, it’s not a choice. Have compassion for people with substance use – meet them where they’re at without judgment.”

• obsession with getting the drug • irritability Post Acute Withdrawal (second stage) The symptoms can last for 2 to 6 months, gradually decreasing: Physical Symptoms • insomnia • weakness, tiredness • poor appetite • muscle aches Psychological Symptoms • unable to tolerate stress • overly concerned about physical discomfort Island health notes that times are approximate; individuals may have symptoms for a shorter or longer period of time.

If any persist or worsen, have them checked by your doctor in case they are related to another problem.

OVERDOSE PREVENTION RESOURCE GUIDE

15

OVERDOSE PREVENTION

A traumainformed approach to substance use Island Health encourages a trauma-informed approach when discussing drug use and overdoses.

This means recognizing and acknowledging trauma, and being aware and sensitive to its dynamics.

Some youth may be more affected by these subjects than others.

Youth may have witnessed family members, friends or significant others using substances, or they may have used themselves.

Youth who have suffered recent losses or who are coping with grief or toxic stress may also be triggered by overdose materials and education.

Teachers are experts in what is developmentally appropriate in educational settings.

YOUTH & SUBSTANCE USE

TALKING

with your teens about drugs While talking about drugs with your teen may not be easy, it is essential.

Chances are teens are hearing about drugs anyway – from friends or social media, for example – but there’s a good chance at least some of that information won’t be accurate.

Sharing factual information and your values, and teaching them how to make safe, healthy decisions about substance use can help prepare them.

While it’s never too early or too late to talk about substance use with your kids, the recent rash of fentanyl-related incidents is a reminder of just how important this conversation is, notes Island Health.

Keeping that line of dialogue open may let them talk about concerns they have about someone else who is using drugs or about their own use. They may want to talk about finding help to stop.

Regardless of their questions, it’s important to provide accurate information.

Health Canada offers the following suggestions: • think ahead about what you want to discuss but avoid saying everything you

16 OVERDOSE PREVENTION RESOURCE GUIDE

think all at once.

• look for opportunities to mention drug use, like when discussing school or current events.

• offer teens control and let them pick the time and place.

• give them room to participate and ask questions.

• respect their independence and their opinion.

• avoid being judgmental.

• listen – if you’re a good listener they may be more inclined to trust your input.

• tell them you’re trying to help them make good decisions by sharing information they may not already have.

• be clear about why you’re worried and tell them that your main concern is for their well-being.

• focus on facts rather than emotions; as a parent, if your teen is using drugs you may feel anger, sadness, fear or confusion, however talking about the issue is more productive than talking about your feelings.

Learn more at islandhealth.ca and Canada.ca.

What Makes Us DIFFERENT THE WHY

Are you tired of relapsing?

Are you tired of people telling you it’s your fault, that you’re not working your program?

Do you want your life back?

YOUR TRAUMA MATTERS! THE HOW

At Armour Addiction Services we have incorporated trauma and expressive arts therapy into our individualized trauma sensitive recovery programs.

We provide affordable, holistic recovery programming that will fit your schedule.

You can live at home and keep working!

We are not a 12-Step program – We specialize in Trauma!

RECOVERY IS POSSIBLE! Take a new step in a different direction.

Armour Addiction Services Inc.

armouraddictionservices.ca 250.619.9324 armourinc@shaw.ca

OVERDOSE PREVENTION

YOUTH & SUBSTANCE USE

IS YOUR TEEN USING DRUGS? HELP IS AVAILABLE If you love and worry about a teenager who may be experimenting with or regularly engaged in relationship with alcohol or other drugs, you’re not alone.

The Island Health workbook, Recognizing Resilience: A Workbook for Parents and Caregivers of Teens Involved with Substances, can help you understand and respond to substance use.

Find additional information and support at Island Health’s Youth & Family Substance Use Resources (islandhealth. ca/learn-about-health/ substance-use-addiction/youth-substance-use).

A consultation with a substance use counselling professional may also be beneficial for your family.

Ask your family doctor or other health care professional for referrals, and visit Island Health’s Youth and Family Substance Use Services page.

Youth & family resources

illegal opioid drugs such as heroin and carry dangerous, unpredictable risks including addiction, overdose and death.

To learn more: islandhealth.ca/learn-about-health/ substance-use-addiction/youth-substance-use

More resources

Additional resources are available from Here to Help, a project of the BC Partners for Mental Health and Substance Use Information, and From Grief to Action, a volunteer-based Some prescription drugs, BC not-for-profit providing a voice and a To learn more about local such as opioid pain relievers, support network for families and friends organizations providing serstimulants and benzodiazeaffected by drug use. vices for youth and families, pines, are used to get high Learn more at fromgrieftoaction.com and see the Resource Guide, because they have psychoactive pages 35 to 37. heretohelp.bc.ca – or mind-altering – properties.

You’ll also find a toolkit (heretohelp.bc.ca/ In fact, Health Canada notes workbook/fgta-coping-kit) for parents or carethat psychoactive pharmaceuticals are givers concerned about a son or daughter’s early the third most commonly used substances experimental substance use or more serious substance among Canadian youth, after alcohol and cannabis. use. Find information about drugs and substance use, However, taking prescription drugs without a docstrategies for supporting a loved one, strategies for tor’s approval is dangerous and can be fatal. taking care of yourself, and treatment options – all from Prescription opioids can be just as dangerous as families who have been there themselves.

Talking about prescription drugs

18 OVERDOSE PREVENTION RESOURCE GUIDE

OVERDOSE PREVENTION

Helping kids make healthy decisions Starting children along the path of healthy choices begins at home, from modelling healthy behaviour to building strong decision-making skills.

By making healthy, responsible decisions around your own use of substances, including caffeine, alcohol, tobacco, doctor-prescribed drugs and illicit drugs, you demonstrate positive behaviour for your children to mimic, says HealthLink BC. This can help children as they grow older and may be more influenced by peers.

What can you do?

Take care of yourself emotionally and physically and enjoy a healthy, balanced lifestyle. Practice safe behaviours and avoid injury.

Follow your prescriptions – stick to the label instructions to show you respect medicines, trust your doctor, and cultivate a healthy relationship with drugs. Demonstrate other ways to

relieve or manage pain besides using opioids or other substances, like going for a walk, meditation or drinking plenty of water. The more equipped children are with strategies to manage pain and other problems, the better able they’ll be at embracing challenges with hope and confidence in their selfcare skills.

If you feel you’re becoming dependent on a substance, talk to someone who may be able to help you re-establish a healthier relationship with substance use. This shows you can recognize a problem and address it.

Help Kids Make Healthy Decisions By helping children learn how to make healthy decisions now, you may be able to help them avoid unhealthy habits later on: • Help them think through reasons they might choose to follow an example or not.

• Talk through your own reasons for making decisions and show how you decide on those steps.

• Offer a manageable number of options when kids are making simple decisions – do you want to bake muffins, cookies or banana bread?

• Sharpen thinking skills with what-if scenarios – what would you do if you won $100? Who would you choose to go on vacation with if we could bring someone? What would you do if you were invisible?

• Encourage slower thinking about decisions so they don’t jump at the first thing they see – why would they rather go skating than play cards?

What would happen if they made a different choice?

• Help them reflect on decisions afterwards – what was good about their decision? What was not so good?

Learn more at healthlinkbc.ca

Camosun’s future-focussed Alex & Jo Campbell Centre for Health and Wellness takes shape As construction nears completion, visitors to Camosun College’s Interurban campus are impressed by the expansive windows and shining steel frame of the striking new $48.5 million Alex & Jo Campbell Centre for Health and Wellness, which is slated to open its doors later this year.

Designed for 21st century learning, the new building will provide a more interdisciplinary approach to education, featuring the most modern, flexible classrooms, with hands-on labs, simulation environments, collaboration spaces for students to gather and a teaching clinic with services to the public. It will bring together the majority of Camosun’s health and human service programming in one location, in order to enhance learning between disciplines, across sectors and with community partners.

“Our focus is on interdisciplinary collaboration, hands-on learning

and community partnerships,” explains Camosun’s Dean of Health and Human Services Cynthia Smith. “The new building will serve as a regional hub for innovation in health and human services education.”

Education and training for the health sector is in high demand in the capital region. “We’re working to prepare our students to improve the patient experience and overall health and well-being outcomes

in our community,” says Smith.

“Successfully addressing complex challenges, whether related to mental health and addictions, seniors and the complexity of care, and many other areas, require new thinking and collaborative approaches.”

that maximise light and space, with open areas that encourage collaborative and interdisciplinary learning. It will provide Camosun learners with the best educational experience in the province.

For more information, please visit: camosun.ca/chw

The building’s design reflects that new thinking—integrating elements that reflect the surrounding natural landscape, local Indigenous culture, and OVERDOSE PREVENTION RESOURCE GUIDEyour 19 Looking to improve employment opportunities?

OPIOID OVERDOSE

HOW ND TO H OWTO TORESPO RESPOND TOAN AN

INSTRUCTIONS :

START

OR

Check for 1 or more of these signs of an overdose: LIPS AND NAILS are blue or grey

GIVE A BREATH

GIVE A BREATH

OR

STRA SNORING or coughin or chokin

BREATHING IS STOPPED OR SLOWER THAN EVERY 5 SECONDS

GIVE A BREATH

GIVE A BREATH GET ALL LIQUID IN THIS HALF

SNAP OFF T HE TOP OF THE AMPOULE It will break in two pieces with little pressure.

SWIRL A MPOULE IN CIRCLES TO GET ALL L IQUID TO BOT TOM

TAKE 1 AMPOULE OUT FROM THE MEDICINE BOTTLE

PLUNGER

GIVE A BREATH

GIVE A BREATH

PUSH AIR OUT OF S YRINGE

UNWRAP SYRINGE. PUT NEEDLE IN LIQUID, PULL UP PLUNGER Try to draw up all of the ampoule’s liquid into the syringe.

Turn the needle facing tip-up, gently push the plunger until most of the air is pushed out.

GIVE A BREATH

FIRMLY PUSH NEEDLE IN THIGH, BUT T, OR UPPER ARM MUSCLE

PUSH PLUNG DOWN HAR

Needle can go through clothes.

Never put it in the heart.

It will click and n will retract

TIPS ON HOW TO GIVE BREATHS : Give 1 breath every 5 – 6 seconds (or 10 – 12 times per minute).

Check airway, remove anything blocking the airway.

You can breathe through the protective face shield from the kit.

Keep an eye on the chest to see if it is rising while you give breaths, and falling as the person exhales.

Document source: www.fraserhealth.ca

20 OVERDOSE PREVENTION RESOURCE GUIDE 20

you give goes into the lungs and doesn’t escape through the nose.

Tilt the head back to open the th If person becomes ill, put person in recovery position.

Are you by you Prepare the nalo between giving

Is someone else Have that perso while you prepa

OVERDOSE PREVENTION

RIGHT AWAY!

Overdoses are a medical emergency & n eed medical care.

ANGE G SOUNDS ng, gurgling, ing sounds

A H

CALL 9 1 1

OR

CANNOT BE WOKEN UP after you call their name or nudge their foot

1. Tell them your location.

2. Explain how the person is not breathing and not responsive.

RUB YOUR KNUCKLES HARD AGAINST THEIR UPPER CHEST To wake the person up.

Call their name. Still unresponsive?

If you haven’t already,

CALL 9 1 1 NOW.

Giving breath is critical.

Give 1 breath ever y 5 seconds whether you have naloxone or not.

Lorem ipsum

PERSON STILL UNRESPONS IVE? CONTI NUE TO N EXT STEP Person breathing normally?

Stop here.

PINCH NOSE, GIVE 2 BIG BREATHS USING FACE SHIELD FROM KIT OR OTHER BARRIER IF NEEDED Check to make sure the chest rises when you give air.

TILT HEAD B ACK, CHECK AIR WAY Remove anything blocking the mouth’s airway.

WHEN THEY WAKE UP : GIVE A BREATH

GER RD

needle t.

urself? oxone breaths.

e w ith y ou? on give breaths are the naloxone.

PERSON STILL UNRESPONSIVE AFTER 3 – 5 MINUTES? GIVE ANOTHER INJECTION

1. Explain what happened because they may have forgotten overdosing.

2. Discourage more substance use for now. The sick feeling will go away nutes). when the naloxone w 3. Wait for the ambulance and encourage the person to go to the hospital.

4. Stay calm, now is not a good time to get upset with the person who overdosed.

Continue to give 1 breath every 5 seconds.

THE RE COVERY PO SITIO N :

Hand supports the head

If you need to leave, or if the person becomes ill, put them in this position:

Knee stops the body from rolling forward onto stomach

For more information visit: www.viha.ca/mho/overdose

OVERDOSE PREVENTION RESOURCE GUIDE

21

OVERDOSE PREVENTION SENIORS & SUBSTANCE USE

SUBSTANCE USE IN OLDER ADULTS While many people think alcohol and drug problems only involve teens and younger adults, all ages can experience problems with drugs and alcohol, including older adults.

Like any demographic, substance use in older adults carries risks beyond health concerns, and can cause potential problems involving money, legal issues and relationships with family and friends, explains HealthLink BC. Often, drinking or misusing medicine or drugs starts after a major life change, such as retirement, the death of a spouse or good friend, or a disease diagnosis.

However, substance use in older adults may be overlooked. Why? Older adults are more likely to drink or use drugs at home rather than in public, and may not have responsibilities such as going to school or work that are affected by substance use.

Additionally, signs of substance use can be similar to those of other health problems many older adults have, such as depression and dementia.

In some cases, caregivers or families may be aware of the problem but may not want to discuss it.

Alcohol – Older adults may need less alcohol than someone younger before become intoxicated, and because their bodies process alcohol more slowly, they may stay drunk longer.

Older adults may also have vision and hearing problems and slower reaction times, which alcohol can worsen, putting them at greater risk for alcohol-related falls, car crashes and other kinds of accidents.

As older adults may be taking numerous prescription and over-thecounter medications, they’re more likely to mix these with alcohol which can be dangerous, HealthLink BC notes.

Medicines – This includes taking too much medicine or taking medicine when you don’t need to, using older medicines or another person’s med22 OVERDOSE PREVENTION RESOURCE GUIDE

icine, taking medicine to feel good or “high” or taking medicines while drinking alcohol. Others don’t take medicine as their doctor directs, such as not taking enough medicine or skipping doses.

Warning signs of substance abuse Signs of alcohol or drug use problems in older adults can include changes in behaviour and mental abilities.

If concerned, a discussion with your doctor should include the drinking or medicine use, now and in the past, as well as over-the-counter medicines, herbs and dietary supplements.

Behavioural changes: • Falling a lot.

• Experiencing incontinence.

• More headaches and dizziness than usual.

• Not keeping yourself clean.

• Changing what and how you eat – you may not eat as much, for example.

• Ignoring or losing touch with family and friends.

• Beginning to think about suicide.

• Beginning to have legal or money problems.

• Changes in mental abilities

Mental signs of drug or alcohol use problems: • Begin to feel anxious much of the time.

• Memory worsens.

• Difficulty focusing or making decisions.

• Losing interest in usual activities.

• Mood swings or feeling sad or depressed.

It’s important to remember that many of the signs listed here can also can be signs of other health problems many older adults have – not necessarily concerns with alcohol or drugs.

What does treatment look like?

Treatment for challenges with alcohol or drug among older adults is the same treatment as for others. In addition to detoxification, medicine and counselling, therapy and 12-step or other support groups may be used.

If medicine misuse is the problem, talking to a doctor, friend or family member may help. Treatment could be as simple as learning more about your medicines and organizing how you take them. You may be able to work with your doctor to reduce how many medicines you take or make it easier to take them.

Learn at healthlinkbc.ca

The number of illicit drug overdose deaths in BC in 2019 equates to about 3 deaths per day.

In Greater Victoria alone we lost almost 100 of our sons, daughters, fathers, mothers, friends and neighbours to fentanyl-related deaths in 2018. But there are things that we can do to stop the overdoses.

Have Courageous Conversations Talking with our friends and loved ones about their substance-use, and the dangers inherent in it – and what precautions they can take is a first step in helping them stay safe.

Parents can play a key role in teaching their children about substance use by talking honestly and openly about the effects of substances and offering clear and simple answers to the tough questions.

Get Involved – be prepared Recognizing the risks and signs of an overdose and knowing how to respond can save someone’s life.

You can pick-up a free Naloxone kit at many locations throughout Greater Victoria. Check out the location finders on the towardtheheart.com website or give your MLA’s office a call to find the most convenient location for you. Naloxone saves lives.

StopOverdoseBC.ca

Brought to you by your South Island NDP MLAs. Contact any one of our offices for more information.

Mitzi Dean, MLA Esquimalt- Metchosin | www.mitzidean.ca | 250-952-5885 Rob Fleming, MLA Victoria-Swan Lake | www.robflemingmla.ca | 250-356-5013 John Horgan, MLA Langford-Juan de Fuca | www.johnhorganmla.ca | 250-391-2801 Carole James, MLA Victoria Beacon Hill | www.carolejamesmla.ca | 250-952-4211 Lana Popham, MLA Saanich South | www.saanichsouth.ca | 250-479-4154 OVERDOSE PREVENTION RESOURCE GUIDE

23

OVERDOSE PREVENTION

WEST SHORE SERVICES

Prevention services in the West Shore communities For those living and working in the West Shore, having overdose prevention services available right in their community is vital.

In addition to the life-saving Opioid Agonist Treatment (OAT), Aids Vancouver Island’s West Shore Health Centre provides a variety of services, including counselling and support.

“I have been told I can call anytime I want to and we are treated like a family here, not just three separate people going through this,” says one local mother whose two sons, 21 and 23 years old, are both patients at the centre. “This is not a clinical atmosphere. Everyone is approachable and knowledgeable and I feel I can talk to everybody here. I appreciate that we don’t have to go downtown, it is in our neighbourhood; downtown is not safe for my boys.”

In the last year the West Shore Health Centre has provided care for more than 170 people struggling with opioid use disorder (OUD) and 24 OVERDOSE PREVENTION RESOURCE GUIDE

at high risk of overdose in the West shore area, says Heather Hobbs, AVI Manager, Harm Reduction Services.

“OAT allows people to receive substance use treatment in their home communities and to be able to continue or get back to work, school and involvement in family and community life,” Hobbs says. “We have been privileged to see first hand the impact of such treatment in the West Shore.

“We have assisted families in supporting their loved ones struggling with OUD. We have assisted parents having their children returned to their home from foster care. It has been gratifying to see young people returning to school and training programs.”

Of the individuals treated at the

centre, 105 were new to OAT, and 70 per cent were men, most between 30 and 49 years old, the demographic disproportionately represented in overdose deaths statistics around the province; many of those patients report using alone and in secret, Hobbs notes.

Young men under age 30, many working in the trades, and also at high risk of overdose deaths, form another large group of patients.

Centre staff also provide care for a small but very vulnerable group of young women and women who are pregnant and parenting.

“The care provided at our clinic also works to improve overall health and wellbeing, which is critical to maintaining OAT treatment,” Hobbs

“I have been told I can call anytime I want to and we are treated like a family here...”

OVERDOSE PREVENTION Continued from page 24

says. “While some of our patients do still struggle with maintaining access to treatment, we understand that relapse is a time to provide more intensive supports. More than 80 per cent of our patients are retained in care at three months, which is a huge credit to our physicians and staff. Over the next year we are working as part of the BOOST collaborative in Vancouver with the goal of increasing retention to 95 per cent.”

Find the AVI West Shore Health Centre at #1112787 Jacklin Rd., where it’s open Mondays from 1:30 to 6:30pm, Tuesday and Thursday from 9:30am to 4:30pm and Fridays by appointment. For more information, call 250-940-3605 (toll-free 1-800-665-2437) or visit online at avi.org/westshore.

Umbrella Society on the West Shore Umbrella Society’s West Shore Group runs Fridays in Langford, a collaboration with Island Health.

The 6-week group offers weekly intake, and is accessible by referral. Info: 250-380-0595

VICTORIA’S VITAL SIGNS MEASURING WELL-BEING, CREATING CHANGE. In 2018, there were 122 Illicit drug overdose deaths in South Vancouver Island, up from 104 in 2017.*

Did you know?

The AVI Health Centre (AVIHC) offers low barrier, free treatment and support to people struggling with opiate addiction. Services include: n Harm reduction supplies and information. n Take-home naloxone trainings. n Peer support groups and educational trainings. n STI (sexually transmitted infection) testing and treatment. n One-minute HIV point of care screening tests. n Patients utilizing OAT treatment or living with HIV can access blood tests, pap smears, immunizations and wound care. n With a harm reduction focus, education, treatment and support for clients living with HCV and HIV. n Condoms, information and counselling about diseases and STIs, prevention and management as well as safer drug use are also available. n Educational materials promoting improved health, safer drug use, safer sex and more.

140 120 100 80

Victoria’s Vital Signs is an annual community check-up 60 that measures the vitality of our region, identifies 40 concerns, and supports action on issues that are critical to our quality of life.

20 For more information, visit our website at victoriafoundation.bc.ca/vital-signs.

0

2014

2015

2016

2017

2018

*Source: Victoria’s Vital Signs and BC Coroner’s Service

OVERDOSE PREVENTION RESOURCE GUIDE

25

OVERDOSE OVERDOSE PREVENTION PREVENTION

REDUCING STIGMA

LANGUAGE MATTERS How to reduce stigma, and why that’s important

When discussing substance use and the current overdose crisis, does language matter?

Yes, say the province’s health professionals.

“Treating people who use substances with respect improves health outcomes and helps save lives,” explains the BC Centre for Disease Control’s Toward the Heart website.

The foundation of Toward the Heart – towardtheheart.com – is that every person has the right to the best health possible and should be treated with dignity and respect.

It’s in this belief that Language Matters.

The goal is to encourage the use of respectful, non-stigmatizing language when describing substance use disorders, addiction and people who use drugs.

“Whether used in a healthcare setting or in the news media, negative and stigmatizing language 26 OVERDOSE PREVENTION RESOURCE GUIDE

discredits people who use drugs and can result in discrimination,” Toward the Heart explains.

“Stigmatization contributes to isolation and means people will be less likely to access services. This has a direct, detrimental impact on the health of people who use drugs.”

How can we change the conversation around overdose?

• Use people-first language.

This means referring to a person before describing his or her behaviour or condition – important because it acknowledges that a person’s condition, illness or behaviour is not that person’s defining characteristic. For example,“person with a cocaine-use disorder” instead of “cocaine user” or “addict.”

• Use language that reflects the medical nature of substance use disorders. Numerous factors contribute to drug addiction, from personal factors to social, environ-

mental and political ones. Avoid terms that reinforce a belief that addiction is a failure of morals or personality, rather than a medical issue. Use “addictive disease” and “substance use disorder” instead of “abuser” or “junkie.”

• Use language that promotes recovery. Use language that conveys optimism and supports recovery, and respects the person’s autonomy, such as “opted not to” and “not in agreement with the treatment plan” instead of “unmotivated” or “non-compliant.”

• Avoid slang and idioms.

Slang terms and idioms have negative connotations and a significant level of stigma attached to them – use “positive” or “negative” when referring to drug tests, for example instead of “dirty” or “clean.”

For more information, including a video about creating a safer space with less stigma, visit towardtheheart.com/reducing-stigma

OVERDOSE OVERDOSE PREVENTION PREVENTION

Images by Jamie Smyth: ‘Jamie Smyth’ and ‘Crumbled Life’ Smyth participated in Island Health’s PhotoVoices project. His image of a piece of metal – straight before becoming crumpled – could be seen as a metaphor for some people’s journeys to substance use and addiction.

IN FOCUS: Photography project tackles images of stigma When the media reports the latest opioid overParisi, communications advisor with Island Health. dose statistics or writes about a tragic death or “We gave them all cameras and sent them in groups even a new treatment program, often the image accom- to capture the images that would have a more positive panying the story is a gritty photo reflecting street life, view of the crisis,” Parisi says. needles, pills or other drug paraphernalia.

“We asked them to pick one or two they really liked Are those images reflective of and we talked about the importhe current overdose epidemic? tance of them, and the response “You could see them Are they helpful to those who was very insightful and hopeful.” currently use substances, to The message was that “we’re really listening and they their loved ones, and to those not bad people, we’re people were listening with their working and volunteering in the who have lived through some heart, not just for the field? bad things.”

Those were some of the quesFor example, “one woman project.” tions asked by Island Health as really wanted to see images that they launched the PhotoVoices were more compassionate so her project, which engaged nine people with lived expephoto was more about reaching out,” Parisi says. rience to share their thoughts of the commonly used For Smyth, who is in recovery, being asked for his imagery. opinion and ideas, and seeing the genuineness and Looking at some of those images, “I found it very compassion on the part of the program facilitators was demeaning; it says, ‘You’re dirty,’ and ‘You’re not want- remarkable. ed,’” says program participant Jamie Smyth. “It sets us “You could see them really listening and they were up as ‘Us’ against ‘Them.’” listening with their heart, not just for the project,” Participants were also asked to share some of their Smyth says. own images that would be more reflective, explains Jen Dr. Richard Stanwick, Island Health Chief Medical OVERDOSE PREVENTION RESOURCE GUIDE

27

OVERDOSE PREVENTION

REDUCING STIGMA

‘I was trying to portray the loneliness’ Continued from previous page Health Officer, expressed his appreciation to the PhotoVoices participants.

“We are so appreciative to hear stories from people with lived experience, who have a vital perspective that helps deepen our understanding of the opioid overdose crisis,” Dr. Stanwick says.

“We need more efforts like this visually evocative initiative to help overcome the stigma still associated with addiction.”

The farreaching impact of a photo

Photo by Beth: ‘Reaching out to help,’ is part of Island Health’s PhotoVoices project.

A selection of images will be on display at The It’s just a photo, Bay Centre during the United Way Greater Victoria’s though, right? What harm can it have?

Overdose Prevention Expo May 8, with additional Research and personal experience suggests it can exhibits possible. in fact have a big impact.

Based on the feedback and results for “It makes it harder for people to come the Victoria project, Island Health is exforward to seek help,” Smyth explains. ploring options to expand the project “Everything is focused on Pandora to other areas, perhaps working Street and alleys and needles, but with the Community Action Teams there’s so much more.” in various Island communities and For many, that’s not the reality of See a selection of images around the province. from the PhotoVoices addiction.

“We need to break through project on display at Smyth chose both a photograph those barriers – that ‘NIMBY,’ Not The Bay Centre during the of himself with Mowry Baden’s United Way’s Overdose In My Backyard, situation is still public art sculpture Night is for Prevention Expo, there,” Smyth says, noting that his Sleeping, Day is for Resting and a May 8. recovery house, Foundation House, photo depicting a piece of metal, run by the Umbrella Society, is among which begins straight before crumpling the best-kept on his street, its residents like an accordion. friendly and helpful to their neighbours.

“I was trying to portray the loneliness, feeling like He appreciates how what was intended to help I don’t fit in, I don’t belong,” he says. “Here, everything is normal, then here, we have this accident and reduce stigma might also help equality come about.

“The collaboration is so impactful.” everything collapses.”

Images on exhibit

28 OVERDOSE PREVENTION RESOURCE GUIDE

OVERDOSE PREVENTION

FAMILY SUPPORT

Drug Overdose and Grief: A Panel Discussion Join individuals impacted by grief as a result of a drug overdose Thursday, May 23 7:30 to 9pm at 4725 Falaise Dr. in Royal Oak.

HELP FOR FAMILIES, FRIENDS CONCERNED FOR LOVED ONES When substance use becomes an addiction, or recreational use leads to unexpected consequences, the impacts affect not only the individual involved, but their entire community of friends and family.

Explains Moms Stop the Harm (MSTH), a network of Canadian families whose loved ones have died from drug-related harms or who have struggled with substance use: “Families have lived experience, and acknowledging their experience and expertise is essential when seeking solutions to the drug crisis. Recognizing families as partners is important. It brings a meaningful voice, a knowledgeable voice to the table during the quest for prevention and treatment of substance use disorders as well as in the policy-making and research process.�

Moms Stop the Harm (MSTH) is a network of Canadian families

whose loved ones have died from drug-related harms or who have struggled with substance use.

Calling for an end to the failed war on drugs, the group instead embraces an approach that reduces harm, and respects human rights, advocating for people who use drugs to be treated with compassion and support, not as criminals.

Healing Hearts peer-led groups meet regularly (typically monthly), offering a supportive place to share their pain with others who have the same experience without stigma and without blame.

You do not have to be a member of MSTH to attend a Healing Hearts peer support group and you do not have to be active in advocacy to join.

To learn more about the Victoria Healing Hearts w/MSTH group, email graspvictoria@gmail.com.

Learn more about Moms Stop the

Harm at momsstoptheharm.com From Grief to Action is a volunteer-based BC not-for-profit that provides a voice and a support network for families and friends affected by drug use.

The organization works to promote recognition of drug use as a health issue; to raise public awareness of the needs and concerns of drug users and their families, and work towards overcoming stereotypes and marginalization; and to provide and promote support for families and friends of drug users.

From Grief to Action also promotes effective educational programs designed to prevent drug abuse and works toward of a comprehensive continuum of care that meets the need for harm reduction, detoxification, treatment and recovery. To learn more: fromgrieftoaction. com OVERDOSE PREVENTION RESOURCE GUIDE

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FAMILY SUPPORT

Supporting yourself through a loved one’s addiction When an individual is struggling with addiction, it affects the entire family. You may find yourself struggling too as you worry for your loved one and try to support them at whatever stage of addiction or recovery they may be experiencing.

You may worry too for the impact on the rest of the family an you may feel embarrassed or guilty about their addiction – wondering if you could have done more, or reacted differently. It’s also natural to feel anger, hurt and disappointment.

Know you’re not alone and don’t blame yourself. Focus on what you can do and let go of what you can’t do. Nobody can force an someone who is addicted to substances to be well, says the community organization From Grief to Action (FGTA).

Educate yourself Numerous organizations are working to support those living with action you agree with and you can work with. addiction and their loved ones (See “If one-on-one help doesn’t resource guide, pages 35 to 37). appeal to you, join a group. There is FGTA also recommends downno substitute for first-hand loading Gone Too Soon: Naviexperience, and severgating Grief and Loss as a al groups (Parents result of Substance Use Forever, Parents Toto read the stories gether, Al-Anon, and experiences of Nar-Anon) offer parents who have The Umbrella Society and Island mutual support lost their children Health offer Connections, a drop-in group for individuals and loved ones from people to drug-related needing immediate support. Created who have been harms. to help those on waitlists, or offer there and are advice for those unsure what to Explore options still struggling do next, simply drop in Tuesday or Whether it’s spirFriday from 2:30 to 3:30pm at with addiction itual support, coun1125 Pembroke St. issues. selling or a new activity Learn more to support your wellness, about some of these at explore options to care for your fromgrieftoaction.com. own emotional wellness.

Stay connected And you don’t have to stick with “This is a time when you need to the first counsellor you meet. Meet reach out to your family and friends, with several until you find one not to withdraw because of feelings whose philosophy and course of

Building Connections:

30 OVERDOSE PREVENTION RESOURCE GUIDE

of shame. After all, both medicine and law recognize addiction as a disease. You’ll be amazed at how understanding most people are,” says FGTA. Care for yourself “How can you help someone else if you aren’t physically and emotionally healthy yourself?” FGTA asks.

“Keep an eye on your own health and well-being. Self-care is not only essential but also can have the additional benefit of modeling coping techniques for your addicted family member.”

Eat well, exercise, go for a walk, and spend time with others you find supportive. Talk to your GP or other health professional if you need more help.

“Above all, don’t give up on your own life, dreams, and goals.”

For more information, visit fromgrieftoaction.com.

OVERDOSE PREVENTION

HARM REDUCTION

HARM REDUCTION: WHAT IT IS, HOW IT WORKS

By Heather Hobbs Manager, Harm Reduction Services, AVI

naloxone kits, supervised consumption services, and medications such as methadone and suboxone to manage opioid addiction.

Harm reduction is sometimes mistakenly understood Harm reduction includes principles, policies and as being different from the goal of abstinence and as practices that aim to reduce the harms associated with merely a stepping stone to ‘real’ recovery. substance use, substance use policies and related social In fact, harm reduction is a way of being in relationconditions. ship that honours the autonomy Grounded in social justice, of each of us to make our own human rights, public health and ex“At its heart, harm decisions about our lives and about periential knowledge or ‘lived/living reduction goes changes we may want to make. experience,’ harm reduction stratbeyond the individual Harm reduction supports us to egies are utilized by many people stay as safe as possible within our who use substances, members of level and has status quo, to make incremental their support networks and service changes if we so choose, and to positive impacts on providers. towards the longer-term Harm reduction is often decommunity health.” work goals we may set for ourselves. scribed as a set of strategies to Harm reduction honours each of keep us as safe as possible when us valuable human beings, where we are at, and where we encounter the various risks present in our lives. For we may want to go. example, car seats and bike helmets can be considered At its heart, harm reduction goes beyond the individharm reduction tools to reduce the risk of serious injury ual level and has positive impacts on community health. when navigating roadways.

For most people who use substances, the harms we In the context of substance use, examples of some commonly known harm reduction resources include the face are related to things like anxiety, isolation, racism, homophobia/transphobia, unmanaged pain, unsupportprovision of sterile needles, needle collection boxes, OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

Did you KNOW?

Be a Good Samaritan

According to the BC Centre for Disease Control’s Toward the Heart, research shows harm reduction activities do not encourage substance use. In fact, they are more likely than other methods to encourage people who use substances to start treatment.

Harm Reduction activities can: • Reduce hepatitis and HIV • Reduce overdoses and deaths • Educate about safer sex and sexual health and increase condom use • Reduce injection substance use and used needles in public places • Increase referrals to treatment programs and services • Increase employment and reduce crime • Reduce sharing needles and other equipment • Educate about safer consumption and reduce use Toward the Heart is part of the BC Centre for Disease Control. We believe every person has the right to the best health possible and should be treated with dignity and respect.

To learn more, visit towardtheheart.com

The Good Samaritan Drug Overdose Act complements the new Canadian Drugs and Substances Strategy, and supports the Federal Action on Opioids and the Joint Statement of Action to address the opioid crisis and prevent further overdose deaths.

The Act provides some legal protection for people who experience or witness an overdose and call 9-1-1 for help, such as: charges for possession of a controlled substance; breach of conditions regarding simple possession of controlled substances in pre-trial release, probation orders, conditional sentences, parole The Good Samaritan Drug Overdose Act applies to anyone seeking emergency support during an overdose, including the person experiencing an overdose. The act protects the person who seeks help, whether they stay or leave from the overdose scene before help arrives. The act also protects anyone else who is at the scene when help arrives.

The act does not provide legal protection against more serious offences, such as: outstanding warrants; production and trafficking of controlled substances; all other crimes not outlined within the act

Harm Reduction Continued from previous page ed mental health and social conditions such as poverty. Substances can be a helpful balm to these harms as well as provide a source of relief, joy and relaxation.

Healthier communities work to reduce social harms and ensure equitable access to the health and social supports we all need. This includes access to a safer supply of substances and policy change to current drug laws that are fueling the current overdose crisis.

When our social conditions support all of our diverse needs, the harms we have typically attributed to substance use are reduced.

For more information on harm reduction: • Harm Reduction International: hri.global/ • BC’s Harm Reduction program: towardtheheart.com • AVI: avi.org

32 OVERDOSE PREVENTION RESOURCE GUIDE

Save a life Staying at the scene is important to help save the life of the person experiencing an overdose.

Witnesses should: • call for emergency help • be prepared by carrying naloxone to use if you suspect an opioid overdose • provide first aid, including rescue breathing (CPR), if necessary, until emergency help arrives; stay calm and reassure the person that help is on the way Tell others about the new Good Samaritan Drug Overdose Act.

OVERDOSE PREVENTION

MEDICATION DISPOSAL

Safe disposal of your medications What do you do with your unused or expired medications?

If you’re like 45 per cent of Capital Region residents, you toss them in the garbage or down the drain.

Not a good idea.

Medication that goes down the drain ends up in the ocean, where it can have a negative effect on the marine environment, explains the Capital Regional District.

And medication in household garbage is not only easily accessible to children, pets and wildlife, but once it reaches the landfill, it can enter the leachate collection system and eventually wind up in the marine environment.

It’s easy to safely dispose of your expired or unused medications.

Simply take your medications to one of the many pharmacies participating in the Medications Return Program. Simply look up nearby return locations by using your postal code at healthsteward.ca Administered by the Health Products Stewardship Association, funded by brand-owners selling pharmaceuticals in BC, the program collects expired or unwanted medication for proper and safe disposal.

In 2015 the Medications Return Program collected more than 11,306kg of unused or expired medications from CRD residents.

While some medications are effectively removed or broken down by sewage treatment, others can pass through treatment and enter the environment unchanged.

“Although the potential impact of pharmaceuticals in the environment is unknown, the best way to minimize the possible effects is to dispose of unused or expired medications at a local MRP-participating pharmacy,” the CRD notes.

No cost to drop off prescriptions The collection, transportation and final disposal of waste medication is funded by the Health Products Stewardship Association.

Medications are collected at the pharmacy in a sealed blue MRP bucket. When full, the bucket is shipped to a licensed facility for incineration.

The CRD suggests emptying non-liquid medication into the blue MRP bucket, and then recycling the packaging when possible. Non-recyclable packaging should be placed in the garbage.

For liquid medication, leave the medication in a container when depositing it into the blue MRP bucket.

Some local pharmacies accept needles and syringes for disposal. Check first with your pharmacist to see if yours does. If not, contact the CRD Information Line at 250-360-3030 to find the closest pharmacy that does.

OVERDOSE PREVENTION RESOURCE GUIDE

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THE RIGHT WAY TO DISPOSAL OF NEEDLES The safe disposal of needles saves others from getting hurt accidentally. Island Health shares what you need to know: • Stay calm; don’t try to replace the cap on needles • Don’t snap, break or bend needles or other sharps • Pick up the needle with care – use work gloves if desired • Hold the needle point away from you • Put needle in a metal or hard plastic container with a lid (i.e. product or drink bottle) • Replace cap on container securely and label it • Wash hands thoroughly with soap and water • Drop off the sealed container at: community drop box (call your municipality about locations); participating pharmacy; dispose of the sealed container in a nearby waste bin; or your local public health unit Anyone who uses a needle to inject should dispose of it safely. However, sometimes discarded needles are found in public areas. Fortunately, the risk of being infected by an accidental needle stick is rare.

If someone is injured by a discarded needle, stay calm, take reasonable care and follow these steps: • Wash the injured area with soap and warm water as soon as possible • Apply an antiseptic and a clean bandage; dispose Call Island Health’s of the needle safely Communicable Disease • Call 8-1-1 for advice program on the South Island 24/7 8:30am to 4:30pm • Visit your local emergen1-866-665-6626 cy department or primary care provider, preferably within 24 hours • For more information, call Island Health’s Communicable Disease program on the South Island, 8:30am to 4:30pm – 1-866-665-6626.

Information about needle stick injuries:

Visit islandhealth.ca/safe-needle-disposal for more information.

Learn more about harm reduction at: towardtheheart.com 34 OVERDOSE PREVENTION RESOURCE GUIDE

Overdose Prevention Expo comes to Bay Centre To share more about Greater Victoria’s experience with the current overdose crisis and measures being taken to prevent overdose, the United Way hosts an Overdose Prevention Expo at the Bay Centre May 8.

Between 11am and 2pm, join health professionals and representatives from local social services organizations to learn about how the region is meeting the needs of those impacted by substance use and overdose.

Guests will also have the opportunity to take a wooden rose in honour of a loved one as part of a photo project. Once 1,510 wooden roses Hosted by United Way Greater Victoria are removed – each from 11am to 2pm representing a life lost to Wednesday, May 8 the opioid epidemic – the face of a survivor will be revealed.

You can also take in Island Health’s PhotoVoices display, featuring images photographed by nine persons with lived experience as a way of combating stigma.

To learn more about how United Way Greater Victoria, visit uwgv.ca/overdoseprevention

Overdose Prevention Expo

OVERDOSE PREVENTION

Resource Guide CRISIS AND SUPPORT LINES 24-HOUR VANCOUVER ISLAND CRISIS LINE – The Vancouver Island Crisis Line

provides a supportive listening ear for people in emotional distress and connection to emergency mental health services when needed. The phone number is the same for all areas of Vancouver Island.

• Call from anywhere on Vancouver Island: 1-888-494-3888 • Crisis Chat services (6 to 10pm nightly) at vicrisis.ca • Crisis Text number (6 to 10pm nightly) 1-250-800-3806 BC211 – Providing free information and

referral regarding community, government and social services in BC. Info: bc211.ca • Dial 2-1-1 on Vancouver Island/Gulf Islands to talk with an Information & Referral Specialist. This service is free, confidential, multilingual and available 24/7.

• TTY – Access for the deaf/hard of hearing community in BC is available by dialing 604-875-0885.

• Text the name of your city to 2-1-1 to chat with an Information & Referral Specialist. This service is free, confidential, and available daily between of 8am and 11pm.

KUU-US CRISIS LINE – The KUU-US Crisis Line is a resource for suicide prevention for Aboriginal people on Vancouver Island and in the province of B.C. Help is available 24 hours a day. If you’re facing a crisis, call any time.

• Adult Crisis Line: 250-723-4050 • Youth Crisis Line: 250-723-2040 • Vancouver Island and through the Province of BC: 1-800-588-8717 BC ALCOHOL AND DRUG REFERRAL SERVICE – 1-800-663-1441 BC MENTAL HEALTH AND ADDICTION INFO LINE – 1-800-661-2121, 9am to 4pm,

Monday to Friday. Sponsored by Canadian Mental Health Association BC Division.

BC DRUG & POISON INFORMATION CENTRE HOTLINE – 1-800-567-8911.

HEALTHLINK BC – Check the HealthLink BC website or dial 8-1-1 for programs in your area.

AA 24-HOUR SUPPORT LINE – Victoria,

VICTORIA COOL AID SOCIETY – Providing prevention, education and counselling, harm reduction, naloxone kits, substance use treatment, supports and access to mental health services, 535 Ellice St., 250-383-1951 ext. 2247, coolaid.org.

NA 24-HOUR SUPPORT LINE – Victoria,

HEALTH, SUBSTANCE USE & RELATED SERVICES

250-383-3553

ISLAND HEALTH – Providing health care

PROBLEM GAMBLING HELP LINE –

services through a network of hospitals, clinics, centres, health units and residential care locations for more than 794,000 people on Vancouver Island, the islands in the Salish Sea and the Johnstone Strait, and the mainland communities north of Powell River and south of Rivers Inlet, including mental health, substance use, addiction and overdoseprevention services. islandhealth.ca

250-383-7744.

1-888-795-6111 8-1-1 – A free-of-charge provincial health information and advice phone line available in B.C., operated by HealthLink BC, part of the Ministry of Health.

OVERDOSE PREVENTION & SUPERVISED CONSUMPTION LOCATIONS THE HARBOUR – Formerly known as Pandora

Supervised Consumption Centre, includes 10 consumption booths, post-use areas, rooms for counselling, medical help, naloxone kits, education and support, 941 Pandora Ave. Info: 250-519-5303 AVI HEALTH & COMMUNITY SERVICES SOCIETY – Harm reduction services, including

an overdose prevention room for safer drug use and rapid overdose response; mobile van (deliveries and used syringe pick-up from Sidney to Sooke), harm reduction supplies and support, overdose prevention and response training, including take-home naloxone education for safer drug use and safer sex, street nurse clinics, referral and assistance navigating social and health care systems, outreach education for youth and prison populations and educational and leadership development programming. 713 Johnson St. Info: 250-889-0268, avi.org.

JOHNSON STREET COMMUNITY – Health services, education for safer drug use, referrals to mental health counselling, links to an on-site nursing clinic, linkages to addiction treatment programs. Please note: This site is open to building residents only. Info: 250-812-1764, phs.ca/project/johnson-streetcommunity

FIRST NATIONS HEALTH AUTHORITY – FNHA is a province-wide health authority

whose vision is to transform the health and well-being of BC’s First Nations and Aboriginal people by dramatically changing healthcare for the better through services largely focused on health promotion and disease prevention. fnha.ca, 1-866-913-0033 HERE TO HELP – A project of the BC Partners for Mental Health and Substance Use Information, a group of seven leading mental health and addictions non-profit agencies that have been working together since 2003 to help people live well and better prevent and manage mental health and substance use problems. Info: heretohelp.bc.ca AVI WEST SHORE HEALTH CENTRE – The AVI

Health Centre (AVIHC) offers low barrier, free treatment and support to people struggling with opiate addiction, #111-2787 Jacklin Rd., 250-940-3605 (toll-free 1-800-665-2437), avi.org/westshore.

PSYCHIATRIC EMERGENCY SERVICES (PES) – Specialized mental health and

addiction services, including intensive assessment and crisis intervention for patients arriving with acute and critical psychiatric disorders. Available via Royal Jubilee Hospital emergency rooms or the 24-hour crisis line: 1-888-494-3888.

OVERDOSE PREVENTION RESOURCE GUIDE

35

OVERDOSE PREVENTION ADDICTIONS OUTPATIENT TREATMENT – Providing services to adults aged 19

and older who are experiencing drug and alcohol problems. In Victoria, self-referral for substance use services is by attending in person at Substance Use Intake at 1119 or 1125 Pembroke St., daily from 9am to 8pm.

VICTORIA UMBRELLA SOCIETY –

Providing support to individuals, and their loved ones, struggling with substance use issues. The society operates three recovery houses and offers counselling for families, outreach services and group sessions. Info: umbrellasociety.ca CANADIAN ARMED FORCES MENTAL HEALTH SERVICES ADDICTIONS TREATMENT PROGRAM – The program

provides assessment and treatment to Canadian Armed Forces members struggling with alcohol, drugs and gambling, as well as other addictions. Patients are assessed by their Primary Care Physician who then works with an addiction counsellor to establish a plan of care and treatment based on the individual’s needs. Treatments include: assessment for substance related and addictive disorders; individual and group treatment; assessment for placement in inpatient alcohol or drug rehabilitation facilities; relapse prevention and follow-up. Additional mental health and stress programs are also available. Info: canada.ca/ en/department-national-defence/programs/ caf-mental-health-services.html#atp

YOUTH & FAMILY SERVICES

ISLAND HEALTH, DISCOVERY YOUTH & FAMILY SUBSTANCE USE SERVICES – Youth

VICTORIA YOUTH EMPOWERMENT SOCIETY (YES) – Youth Detox and Shelter,

life skills program, mental health liaison, counselling for sexually exploited youth and support for transitional housing. Info: 533 Yates St., 250-383-3514 or vyes.ca VICTORIA YOUTH CLINIC – Youth

counselling, outreach support, vaccines and medical testing; Foundry Centre.

Info: 818 Douglas St., 250-383-3552, victoriayouthclinic.ca FROM GRIEF TO ACTION – A not-forprofit society working to improve the lives of addicted youth and their families and friends, and a voice and a support network for families and friends affected by drug use. fromgrieftoaction.com BOYS AND GIRLS CLUB OF VICTORIA: VYPER – Victoria Youth Program for Enhanced

Recovery supportive recovery program and parenting programs, 301 - 1195 Esquimalt Rd. Info: 250-384-9133 (ext. 216), bgcvic.org PACIFIC CENTRE FAMILY SERVICES ASSOCIATION – Promoting dignity and

quality of life for families and individuals across Greater Victoria, especially on the West Shore, through education, counselling and creative programming since 1968. Find a wide range of vital services for people dealing with substance use, mental health issues, and day-to-day life challenges. Info: 250-478-8357, pacificcentrefamilyservices.org

westshore Support, education, advocacy and referrals for people who use drugs free substance use treatment and support for people who use drugs • mobile harm reduction services peer and family support groups • take-home naloxone 111-2787 Jacklin Rd, Langford Toll free Infoline: 1-800-665-2437 westshore@avi.org | www.avi.org

36 OVERDOSE PREVENTION RESOURCE GUIDE

RESOURCE GUIDE

and family counselling, youth outreach services, prevention and early intervention, Esquimalt Health Unit, 530 Fraser St., 2nd floor. Info: 250-519-5313, Discovery.

SouthIsland@viha.ca VICTORIA NATIVE FRIENDSHIP CENTRE – Dedicated to improving the quality of life

for Aboriginal people in the Greater Victoria area, the Friendship Centre offers a variety of programs, including career, education and employment resources, family service, a wellness clinic, community support, addictions counsellors and more. 231 Regina Ave. Info: 250-384-3211, vnfc.ca.

SOOKE FAMILY RESOURCE SOCIETY – Youth

outreach and navigator service. Info: 105 – 2145 Townsend Rd., 250-642-5152, sfrs.ca ESQUIMALT MILITARY FAMILY RESOURCE CENTRE – The MFRC is a community-based

organization with the sole responsibility of addressing the needs of the military family and medically released members and their families. Professional, caring prevention, support and intervention staff offer support with deployment relationship issues, relocation, the military lifestyle, and a variety of short-term crisis situations, in addition to quality referrals to outside counselling resources and specialized counsellors. Info: 250-363-2640 , esquimaltmfrc.com THE FOUNDRY – Foundry offers young people ages 12 to 24 health and wellness resources,

Support, education, advocacy and referrals for people who use drugs Victoria: harm reduction drop-in • overdose prevention services free naloxone kit distribution • referrals and assistance support for clients living with HIV and Hepatitis C education & resources for safer drug use, safer sex, sexual health & gender diversity Westshore: free substance use treatment and support for people who use drugs mobile harm reduction services • peer and family support groups take-home naloxone

1-800-665-2437 • www.avi.org

OVERDOSE PREVENTION services and supports – online and through integrated service centres. In Victoria at 818 Douglas St., visit Monday to Thursday from 11am to 5pm and Friday, 11am to 4p.m. (includes walk-in physical health services); walk-in counselling available Monday to Friday from 11am to 3pm. Info: 250-383-3552 or foundrybc.ca/victoria/

COMMUNITY-BASED RECOVERY SERVICES & SUPPORTS ANAWIM COMPANIONS SOCIETY –

Offering support for people living in physical, emotional, spiritual and social poverty, this private men’s residential alcohol and drug treatment program provides for basic needs while encouraging personal development.

Also offers a free drop-in day program for men and women in need. 973 Caledonia Ave., anawimhouse.com, 250-382-0283.

OASIS SOCIETY – Works with homeless and

newly housed people to create a shared and inclusive spiritual community. The Integrated Recovery and Holistic Wellness Program provides supports to Indigenous people dealing with chronic homelessness, substance abuse and mental health challenges.

Community meals held every Tuesday. Also holds nature-based retreats where people can connect to one another, themselves, nature and elders, and in First Nations ceremonies.

Room 12, 710 Cormorant St., 250-361-0036, oasisvic.org.

VANCOUVER ISLAND MEN’S TRAUMA & COUNSELLING SERVICES – Supporting

anyone who identifies as a man who has experienced emotional, sexual or physical trauma as a child or an adult, with victim services, counselling and group programs.

102-1022 Pandora Ave., 250-381-6367, menstrauma.com GREATER VICTORIA CITIZEN’S COUNSELLING CENTRE – The Greater

Victoria Citizens’ Counselling Centre offers affordable, accessible counselling to adult residents of Greater Victoria. All counselling is offered by volunteer counsellors trained and supervised by the Centre. Sliding fee scale based on family income. 941 Kings Rd., 250384-9934, citizenscounselling.com

SOUTH ISLAND CENTRE FOR COUNSELLING & TRAINING – Providing

affordable, income-based counselling services to individuals, couples, children, youth and families around a variety of issues, including anxiety, depression, grief and loss, end-of-life, self-esteem, abuse, and family conflict. Office hours: 9am to 5pm Monday to Friday with openings most evenings from 4 to 8pm and some Saturday appointments. 3821A Cedar Hill Cross Rd., 250-472-2851, southislandcentre.ca.

PEERS VICTORIA RESOURCE SOCIETY – a

multi-service grassroots agency established for sex workers, by sex workers, providing an array of outreach and drop-in, harm reduction and support services along with education and employment training for current and former sex workers. Main office hours 11am to 3pm Monday to Thursday. 1-744 Fairview Rd., 250-388-5325, safersexwork.ca

COUNSELLING & ADDICTION TREATMENT ARMOUR ADDICTION SERVICES –

Providing long-term solutions for recovery from addiction with accessible, timely and responsive addiction treatment. Focusing on advocacy, education and empowerment.

203 – 920 Hillside Ave., 250-619-9324, armouraddictionservices.ca BURNS CLINICAL LIFE OPTIONS – A caring

and dedicated private recovery clinic offering addiction and mental health care services since 2002. Their experienced counsellors and evidence-based group therapy work to aid clients in maintaining long-term wellness.

102-1245 Esquimalt Rd., 250-590-3168, addictionsvictoria.com CEDARS COBBLE HILL – Offering a full

continuum of addiction recovery programs for men and women designed to provide a framework for sustainable recovery. Cedars specializes in the treatment of alcohol and drug addiction, and various process addictions including eating disorders and gambling.

Treating clients in every stage of recovery provides invaluable continuity of care that ultimately means the best chance for longterm success. 250-733-2006, cedarscobblehill.com EDGEWOOD – A premier, private residential

alcohol and drug rehab addiction treatment centre specializing in the treatment of

RESOURCE GUIDE addiction and mental health from its Nanaimo campus, with full-time, ASAM/ABAM-certified medical doctors who are experts in the field of addiction medicine and psychiatry, including drug and alcohol withdrawal treatment. 2121 Boxwood Rd. Nanaimo, 1-800-683-0111, edgewoodhealthnetwork.com LASER CENTERS FOR HEALTH – Outpatient treatment centre offering highly effective drug, alcohol, and nicotine addiction treatment. Also treats stress, PTSD, depression, anxiety, insomnia and more. Cold soft laser acupressure calms nerves and eliminates withdrawal. Includes natural detox, healthy lifestyle counselling, and ongoing support.

Treatments are confidential and take less than 90 minutes, after which you can return home or to work.. #214 -1595 McKenzie Ave., 250-385-2737, lasercentersforhealth.com HOMEWOOD RAVENSVIEW – Providing

immediate, expert treatment for clients living with mental health, addiction and concurrent conditions, with psychiatrists, addiction medicine physicians, psychologists, specialized therapists and a 24/7 nursing staff working closely with the Homewood Research Institute to incorporate the latest research and clinical innovations. 1515 McTavish Rd., North Saanich, 1-866-203-1793, ravensview.com

RESOURCES Recognizing Resilience: A Workbook for Parents and Caregivers of Teens Involved with Substances, keltymentalhealth.ca Toward the Heart offers information on fentanyl and naloxone: towardtheheart.com Island Health’s Discovery Youth and Family Substance Use Services: viha.ca/youthsubstance-use/discovery HealthLink BC has overdose information and nurses available by calling 811 or visiting healthlinkbc.ca Mindcheck is an online resource for youth and families offering mental health resources and support: mindcheck.ca Here to Help BC offers a Resiliency Guide for Parents and Youth: heretohelp.bc.ca Keeping Youth Connected, Healthy & Learning (for school administrators): viha.ca/ NR/rdonlyres/D37BC183-1B0E-4F0B-B9495A8870A6049F/0/keepingyouthconnected.pdf

OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

Overdose Prevention Guide A special community project published by the Victoria News and Monday Magazine Group Publisher Penny Sakamoto, psakamoto@blackpress.ca Publisher Ruby Della Siega ruby@mondaymag.com Editor Jennifer Blyth jblyth@telus.net Creative Director Lily Chan

Design Michelle Gjerde Cara Robbins Videographer Arnold Lim

vicnews.com mondaymag.com To request more copies, call 250-360-0817

RESOURCE GUIDE

About this project Recognizing the tragic consequences the current opioid crisis is having on our community, Monday Magazine, Victoria News and Black Press Media wanted to find a way to respond in a meaningful way – to make a difference.

Inspired by our sister publication in Washington State, the Everett Herald, and the work being done by so many here at home, we created the Overdose Prevention Guide.

This publication would not have been possible without our community partners, The Victoria Foundation, United Way Greater Victoria, Camosun College and the Saunders Family Foundation, in addition to the support of the teams at Island Health and AVI. Thank you all for making a difference.

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