August 4, 2021

Substance use: What you need to know

FRASER VALLEY

Overdose Prevention

2021 RESOURCE GUIDE

What are opioids? n Know the risks n Avoiding overdose n Getting help n

COMMUNITY PARTNERS

PLUS… Who to call n How to help n Teens & Seniors n

A COMMUNITY COMING TOGETHER FOR FRASER VALLEY’S OVERDOSE EPIDEMIC

Save A Life - Talk About It! The illicit drug-poisoning crisis is a complex public health emergency with no easy solution. Stigma is discrimination against someone based on a distinguishing characteristic or behaviour thought to be shameful. The stigma attached to substance use keeps people from talking about it, but it is crucial to talk and build connections to ensure no one suffers alone. Break the silence, talk about it – save a life!

The Mission Overdose Community Action Team (MOCAT) brings together community members (service agencies, people with lived experience, family members, business owners, healthcare providers) to facilitate local partnerships, coordinate programs and services, address gaps, and plan for a compassionate community response.

We coordinate practical community projects, like the Community Garden at In-Phase Treatment Clinic, and provide community education, dialogue sessions, naloxone training, and events for International Overdose Awareness Day (IOAD).

Email stopoverdosemission@gmail.com for more information on how to get involved and help with this vital work.

GET READY FOR OVERDOSE AWARENESS DAY • JOIN WITH MOMS STOP THE HARM

Art Show - community art displayed in downtown businesses, Live Music, resource tables, refreshments, naloxone training, conversation.

For more information email: stopoverdosemission@gmail.com

TIE A PURPLE RIBBON FOR SOMEBODY’S SOMEONE Please Join Moms Stop The Harm, as we tie ribbons for all those lost who were somebody’s someone in the month leading up to Overdose Awareness Day August 31. We encourage you to wear purple and tie a ribbon of remembrance in recognition of loved ones lost. We also invite folks to share photos of their ribbon(s) at

http://www.facebook.com/groups/PurpleRibbonForOverdoseAwareness Let’s paint the town PURPLE the week of IOAD and bring awareness to the devastating losses and countless families mourning as a result of this Overdose Crisis.

stopoverdosemission@gmail.com www.momsstoptheharm.com

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OVERDOSE PREVENTION RESOURCE GUIDE

SPECIAL REPORT: OVERDOSE PREVENTION

‘Who is affected? We all are.’

Fraser Health is responsible for the delivery of health services to over 1.9 million people in 20 diverse communities from Burnaby to Fraser Canyon on the traditional territories of the Coast Salish and Nlaka’pamux Nations.

Teams across Fraser Health have worked to integrate harm reduction and overdose prevention into their practice. We have distributed naloxone kits and trained people to use them to reverse overdoses. Drug checking and alerts for sudden increases in overdose and toxic drugs help keep people safer.

We have expanded the availability of safer pharmaceutical options to the toxic drug supply, partnered with BC Housing to integrate witnessed consumption services into housing models and created health contact centres that provide wrap-around mental health and substance use services.

Our efforts continue to evolve to meet the needs of people who use substances and those who support them.

Learn more about our services and supports at fraserhealth.ca/substanceuse

Established in 2000, Fraser Valley Health Care Foundation set out to help support the facilities and programs operated

by Fraser Health in Mission, Abbotsford, Chilliwack, and Hope. Our vision is to improve the quality of health care for our local communities.

The opioid crisis in our region, and the rest of the Province, tragically is putting our quality of life and health care at risk.

This crisis not only affects those who overdose but those closest to them, first responders, health care providers, and the community as a whole.

We all have a role to play. We are here to support the programs put forth

by Fraser Health to combat the diverse set of issues that face our region on a daily basis. Helping donors decide where their funds will make a real impact, is paramount to our community’s well being It is our hope that this guide will raise the awareness and support those that need answers and help guide individuals struggling with the impacts of addiction.

Central to UFV’s mission is community, or St’elt’elawtex in the language of the Stó:lo people. The university cultivates strong relationships, acting as a hub where all kinds of communities — educational, scholarly, local, global, and cultural — connect and grow.

As BC tackles this public health crisis affecting every region of the province and every socio-economic group, UFV provides educational programming and support services aimed at treating addiction and helping prevent overdoses in the Fraser Valley and beyond.

UFV strives to help our region develop preventative strategies in many ways: through our centres which conduct applied research in our communities, through educational programming in Health Sciences and Social Work and Human Services, and by providing frontline preventative information and assistance to students, faculty, and staff.

The university is pleased to support the publication of this guide. Education and accurate health information are essential in reducing harm caused by overdoses and drug misuse. Only through learning and the application of knowledge will meaningful and lasting change occur around this complex and life-threatening issue.

Mission Community Services (MCSS) is a local, non-profit organization, which aims to find effective long-term solutions to clients’ complex needs. One of the areas that MCSS focuses on is to reduce the incidence of drug-related health and social harms, through providing low-barrier and peer driven harm reduction services to the community.

Their housing programs follow housing first and harm reduction principles, which mitigate the potential negative impact of substance use in the community.

Through their housing and outreach departments they provide the community with a variety of harm reduction services, including provision of clean drug use supplies, delivery of Take Home Naloxone, safe disposal, inappropriate sharps pickup, education, advocacy, and overdose prevention locations for both youth and adults accessing services.

Since its inception in 1972, Mission Community Services has been committed to their vision of Helping People, Changing Lives, and Building Community.”

MCSS is thankful to partner with the Stone Soup initiative in Mission for participation in this magazine. The Stone Soup Initiative is a collaboration of community members, NPO’s and other partners who come together to make a difference in tackling the problems of poverty and homelessness.

Fraser House Society offers substance use counselling, prevention and health promotion services to adults, youth and families in Mission and surrounding areas. Our clients seek support for their own substance use or because they have been affected by the substance use of someone they love. We are devastated by the tragic losses experienced by families in our community due to contaminated drugs. Let’s protect our communities. Please have open conversations with friends and family and help reduce the stigma attached to substance use.

Please learn about naloxone, stay safe and help keep others safe. Fraser House is supported

by Fraser Health and Community Action Initiative.

Pacific Community Resources Society (PCRS) has been offering services in education, employment, housing, substance use, mental health, and youth and family supports for over 37 years.

Programs like Chilliwack Health and Housing Centre provide safe and welcoming substance use programming for youth and adults. Services are offered in prevention, outpatient counselling, support groups, treatment, distribution of harm reduction supplies, Naloxone training/drug checking, housing, Indigenous wellness, Indigenous peer programming, and substance-affected supports for family and loved ones.

We are committed to walking alongside our communities in facing this overdose crisis head on.

OVERDOSE PREVENTION RESOURCE GUIDE

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What’s inside

Overdose crisis

BY THE NUMBERS: O verdose deaths in B.C. in 2020: 1,726 Deaths in Fraser Health in 2020: 574 O verdose deaths in B.C. in first 5 months of 2021: 851 Deaths in Fraser Health in first 5 months: 291 Provincial data from Jan. 1 to May 31, 2021: I n May 2021, there were 160 suspected illicit drug toxicity deaths – equates to about 5.2 deaths per day. This is the second largest number of suspected deaths ever recorded in the month of May (May 2020 had 177 deaths).

I n 2021, 70 per cent of people dying have been aged 39 to 59. Males have accounted for 80 per cent of the deaths.

I n 2021, 85 per cent of deaths occurred inside, 56 per cent in private residences and 29 per cent in social and supportive housing, SROs, shelters, hotels. Only 14 per cent occurred outside.

No deaths have been reported at supervised consumption prevention sites.

How we can help

BC launches Safe Supply Access.....................5 What is 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 Patients help break cycles..............................17 Inequities faced by Indigenous Peoples.........18 How to respond to opioid overdose .............20 Substance use in older adults .......................22 Hidden population ........................................24 Language matters: fighting stigma...............26 Call it a Haircut ministry with a twist.............27 Path given doesn’t dictate the path taken.....28 Myth’s about BC’s overdose epidemic...........29 Addiction is a battle ......................................31 Naloxone Training .........................................33 Safe disposal of medications & needles.........34 Resource guide..............................................35

Emergency and Extreme Weather Shelter Second Stage Housing Homeless Outreach and Prevention Family Development and Resources Youth Services Child Care and Resource Referral Family Place Settlement and Immigration Services Seniors Services Food Centre Christmas Bureau

For more information, contact us today at: (604) 826-3634 info@missionmcss.com

www.missioncommunityservices.com 4

OVERDOSE PREVENTION RESOURCE GUIDE

OVERDOSE PREVENTION

SAFE DRUG SUPPLY

BC becomes 1st in Canada to launch province-wide prescribed safer drug supply access Program to include prescription fentanyl patches, as well as injectable and tablet forms of hydromorphone

A woman holds up a sign bearing a photograph of Morgan Goodridge during a memorial march to remember victims of overdose deaths in Vancouver on Saturday, August 15, 2020.

(THE CANADIAN PRESS/Darryl Dyck)

People across B.C. struggling with addiction will soon have expanded access is backed by $22.6 million over three years, access to prescribed safe drugs, amid a deadly and toxic which will be used by the five health authorities to support street-level supply that has killed thousands. planning and phased implementation.

The program, which was piloted in 2020, will This year is shaping up to becoming the worst year include access to fentanyl patches, as well as inin B.C.’s history for toxic drug poisonings, with jectable and tablet forms of hydromorphone.

851 lives lost between January and May. That’s “Today’s policy builds on what we compared to 569 fatalities during the same learned from the pandemic,” Addictions time period in 2020, and 654 in 2018 – the Minister Sheila Malcolmson said during a • call 9-1-1 immediately first and second deadliest years since toxicity news conference. death stats were made public in 2011.

• provide rescue breathing “This new policy will help to separate Illicit fentanyl, and drugs such as heroin (mouth-to-mouth) more people from the poisoned supply and and cocaine laced with the toxic substance, • administer to help them connect with support and to were found in 85 per cent of deaths so far naloxone stabilize their lives.” in 2021. Seventy-five deaths have been linked Phase 1 of the rollout will see prescription to illicit carfentanil, an opioid used to tranquilize access in existing programs across the province. The large animals, such as elephants.

Overdose: What to do:

OVERDOSE PREVENTION SITE Overdose prevention sites aim to prevent drug overdoses and overdose deaths, and reduce the adverse health, social and economic consequences associated with substance use.

Sites provide overdose prevention education, Take Home Naloxone training and distribution, onsite monitoring of people who are at risk of overdose and rapid response where necessary. They also provide harm reduction supply distribution and disposal options, and

facilitate referrals to mental health and substance use services.

Phoenix Society Call for Hours | 604-854-1101 32883 South Fraser Way, Abbotsford Note: Overdose prevention services may be provided by additional organizations within the Fraser Health region.

Services vary at each site.

OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

ABOUT ADDICTION

What is fentanyl?

Opioids: What they are + how they work

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?

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.

A cheap way for drug dealers to make seeing high rates of overdoses and related street drugs more powerful, illegal fentanyl deaths. and fentanyl-like drugs such as carfentanil Illicit fentanyl is manufactured in clandesare contaminating Canada’s illegal drug tine drug labs, overseas and in Canada. It supply. may be cut into powders or pressed At 20 to 40 times more into pills, says the BC Centre potent than heroin and of Disease Control website, 100 times more potent Toward the Heart. than morphine, the risk Fentanyl is sometimes of accidental overdose sold as fentanyl but other No Judgement. is very high, especially illegal drugs can also contain when street drugs can it, including heroin, cocaine, Just Love. contain unknown amounts oxycodone, crack or meth.

888-688-NORS of fentanyl. It can be mixed It may be in powder, liquid (6677) with drugs, and is found in or pill-form drugs. These may counterfeit pills made to look like contain toxic contaminants or have prescription opioids. different levels of fentanyl in each batch.

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

National Overdose Response Services

British Columbia Health officials recorded

1,716 deaths

due to Illicit drug use last year.

Don’t let someone you love become another statistic.

WE CAN HELP STOP THE CYCLE

• One-to-One Substance Use Support • Those impacted by a loved one’s substance use • Connection and Relationships • A Safe Space 6

OVERDOSE PREVENTION RESOURCE GUIDE

604-860-5759

to talk to someone today.

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 health issues like liver or lung n You mix substances: 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 Use the Lifeguard app. 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. n Be prepared and make a plan to call 9-1-1

Choose a safer route of taking drugs SAFER / NO USE

SWALLOWED

SNORTED / SMOKED / INSERTED

INJECTED

MORE LIKELY TO OVERDOSE

Source: www.towardtheheart.com *with the increased toxicity of drugs circulating - risk of overdose can be present from all routes of administration OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

NALOXONE

What is naloxone?

Naloxone is a very safe 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.

While naloxone works quickly – within three to five 8

OVERDOSE PREVENTION RESOURCE GUIDE

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.

To find the closest place to access naloxone, please see: https://towardtheheart.com/site-finder For a complete list where to find Naloxone Kits see pages 10-11 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.

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OVERDOSE PREVENTION

Where can I find NALOXONE? ABBOTSFORD

Abbotsford Addictions 202 - 31943 South Fraser Way 604-850-5106 Abbotsford Health Centre 33634 Busby Road 604-870-9925 Abbotsford Health Unit 104 - 34194 Marshall Road 604-864-3400 Abby Pharmacy 100 - 2845 Cruickshank Street Fraser Valley Aboriginal Children and Family Services Society 3010 Gladwin Road 604-855-3328

Mt. Lehman Pharmacy 110 - 30495 Cardinal Avenue 604-856-7176 Otter Co-Op Pharmacy 250 - 3270 Mt. Lehman Road Pathways Health and Wellness Centre 1 - 2316 McCallum Road 604-746-6020 Pharmasave (Midtown) 101A - 2359 Clearbrook Road 778-880-7011 Phoenix Society 108A - 32883 South Fraser Way Real Canadian Superstore 2855 Gladwin Road 604-557-5235

Bula Pharmacy 33634 Busby Road 604-850-2588

Riverside Winter Shelter 1640 Riverside Road

Centre of Hope 34081 Gladys Avenue 604-852-9305

Safeway (Clearbrook Town Square) 100 - 32500 Fraser Way S 604-852-3558

Costco Pharmacy 1127 Sumas Way Gladwin Pharmacy 104 - 2955 Gladwin Road 604-850-2494 Hub Pharmacy 108 - 32883 South Fraser Way 604-556-8515 Impact Youth and Family SUS 101 - 32555 Simon Avenue 778-347-8664 Langdon Pharmacy 108 - 2669 Langdon Street London Drugs Pharmacy (Clearbrook) 26 - 32700 South Fraser Way London Drugs Pharmacy L110 - 3122 Mt. Lehman Road Marshall Pharmacy Ltd 33774 Marshall Road 604-859-8333 McCallum Health Centre 1 - 2316 McCallum Road 604-746-6020

Shoppers Drug Mart Pharmacy (Sumas Mountain) 2332 Whatcom Road 604-851-8635

CHILLIWACK

The Medicine Shoppe D - 2388 McCallum Road 604-776-1000

Chilliwack General Hospital-Primary Care Clinic 45600 Menholm Road 604-702-2850

The Warm Zone (SARA For Women) 33264 Old Yale Road 604-746-3301 Winmed Pharmacy 104 - 32450 Simon Avenue 604-746-0201 Your Community Pharmacy 104 - 2596 McMillan Road 604-851-9654 Your Independent Grocer 32900 South Fraser Way 604-859-6501

AGASSIZ

Save-On-Food Pharmacy 2140 Sumas Way

Agassiz Community Health Centre 7040 Cheam Avenue 604-703-2030

Save-On-Foods Pharmacy (East Abbotsford) 101 - 1888 North Parallel Road

Agassiz Health Unit 7243 Pioneer Avenue 604-793-7160

Save-On-Foods Pharmacy 2388 Whatcom Road

Chehalis Band Store 1001 Chehalis Road 604-796-9252

Shoppers Drug Mart Pharmacy (Gateway Medical) 103 - 2051 Mccallum Road 604-853-1624 Shoppers Drug Mart Pharmacy 1 - 2871 Livingstone Avenue 604-851-8052 Shoppers Drug Mart Pharmacy (Sevenoaks) 143 - 32900 South Fraser Way 604-853-9481 Shoppers Drug Mart Pharmacy 1 - 32390 South Fraser Way 604-850-3517

Midtown Health Centre 101 - 2359 Clearbrook Road 604-746-7868

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Sasquatch Crossing Ecolodge 15500 Morris Valley Road Harrison Mills 604-796-9798 Seabird Island Health Centre 2895 Chowat Road 604-796-2177 Seabird Pharmacy 2895 Chowat Road 604-491-4477 Shoppers Drug Mart Pharmacy 100 - 7130 Pioneer Street 604-796-2241

Cedarview Clinic 9380 College Street 604-703-6986

Chilliwack Health Unit 45470 Menholm Road 604-702-4900 Chilliwack Health & Housing Centre (PCRS) 45921 Hocking Avenue 604-798-1416 Chilliwack Trethewey Modular Housing 45980 Trethewey Avenue 604-392-8729 Gaetz Pharmacy 103 - 45744 Gaetz Street 604-846-3603 Garrison Pharmacy #1 - 45555 Market Way 604-846-8782 Lock’s Prescription Pharmacy 9181 Main Street London Drugs Pharmacy 21 - 45585 Luckakuck Way Pharmacy 24-Chilliwack 101 - 5625 Promontory Road 604-705-3644 Pharmasave-Chilliwack 110 - 9193 Main Street 604-792-1240 Pro-Health Pharmacy 8999 School Street 604-845-8084 Real Canadian Superstore Pharmacy 45779 Luckakuck Way 604-824-4235 Riverstone Detox 45600 Menholm Street Safeway Pharmacy 45610 Luckakuck Way 604-858-0437

OVERDOSE PREVENTION

NALOXONE

Safeway Pharmacy 45850 Yale Road 604-795-6092 Sardis Pharmacy 7-7201 Vedder Road 604-705-1030 Save-On-Foods Pharmacy 46020 Yale Road Save-On-Foods Pharmacy (Sardis) 31 - 6014 Vedder Road Shoppers Drug Mart 45800 Promontory Road 604-824-1036 Shoppers Drug Mart 110F - 6640 Vedder Road 604-847-3496 Shoppers Drug Mart (Southgate) 45905 Yale Road 604-792-7377 Sigma Health Centre 102 - 46198 Yale Road 604-615-9606 Skwah First Nations 615 Wellington Avenue 604-792-9204

MISSION

Mission Friendship Centre 33150A 1st Avenue 604-826-1281

Traverse Youth Center 45921 Hocking Avenue 604-795-5994

Deroche General Store 41679 Lougheed Highway 604-826-3990

Mission Health Unit 7298 Hurd Street 1FL 604-814-5500

Yale Road Pharmacy 101 - 46198 Yale Road 604-795-1157

Fraser House 33063 4th Avenue 604-826-6810

Mission Youth House (Youth Only) 7368 Proctor Street 604-287-7200

Wellness Pharmacy No. 12 100 - 9123 Mary Street 604-795-9501

FreshCo-Mission 32520 Lougheed Highway 604-826-5398

Mission Pharmacy C - 33082 1st Avenue 604-287-7190

Haven in the Hollow 32646 Logan Avenue 604-820-9008

Pharmasave 110 - 7343 Hurd Street 604-820-1669

Leq’a mel Esso On the Run 43101 Lougheed Highway 778-536-8812

Real Canadian Superstore 32136 Lougheed Highway 604-820-6435

London Drugs Pharmacy 200 - 32555 London Avenue 604 820 5115

Save-On-Foods Pharmacy 400 - 32555 London Avenue 604-820-7622

The Village - Youth Services 8937 School Street 604-702-2903

Care In Pharmacy 33083 1st Avenue 604-287-2999

HOPE

First FNHA (Fraser Reiver Indigenous Resiliency Support Team) 63861 Old Yale Road 604-860-9484 Hope & Area Transition Society 400 Park Street 604-869-5111 Hope Health Unit 444 Park Street 604-860-7630 Hope MHSU 1275A 7th Avenue, 604-860-7733 Thunderbird Motel 63030 Flood Hope Road 604-869-1880 Yale First Nation 314 Hudson Bay Street 604-869-0013

Shoppers Drug Mart Pharmacy 32530 Lougheed Highway 604-826-1244 OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

Overdose epidemic: Who is really affected?

Who is affected by the current overdose epidemic?

The quick answer is simple – everybody. Experts agree that the overdose epidemic affects everyone, from the health care professionals to the more typical people thought of as the street entrenched.

And everyone in between.

For example, the picture of 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, including the recommendation that individuals who are going to use, not use alone.

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; 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.

Among the Indigenous community, it’s estimated the impact is three to five-times higher than the general population.

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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 people to recognize the dependency on opioids.

According to health authority experts, the crisis has forced them 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.

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,” said one expert.

When Waiting for Detox is not an Option

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Our experienced team of medical professionals will ensure your safe withdrawal from opioids and will discuss post-detox therapies such as Suboxone. Take advantage of state-of-the-art withdrawal protocols designed to minimize discomfort and side effects on our 12-acre beachfront campus on BC’s Sunshine Coast. All fees for our medical detox program are tax exempt and tax deductible.

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OVERDOSE PREVENTION RESOURCE GUIDE

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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.

Fraser Health’s Opioid Agonist Treatment clinics provide comprehensive care and facilitate connections to other healthcare services and community supports (e.g. Primary Care, counselling etc.).

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.

How Opioid Agonist Therapy works: “Very quickly after starting to use opioids, you can become physically dependent. 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. It helps stabilize the person, giving them the space they need to work on the other challenges such as physical and mental health concerns, housing and financial instability and other personal challenges that are contributing to their harmful substance use.

By acting slowly in the body, the 14 OVERDOSE PREVENTION RESOURCE GUIDE

therapy prevents withdrawal without causing a person to get high. 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. 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.

Methodone 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.

OVERDOSE PREVENTION Continued from previous page 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 walkin clinic or contact a community OAT clinic to learn about treatment availability.

• In Abbotsford visit Archway Community Services, 202-31943 South Fraser Way. • IIn Chilliwack visit Chilliwack General Hospital at 45600 Menholm Rd. • In Mission visit Mission Community Health Centre at 7298 Hurd St. 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.

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.

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.

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

OAT TREATMENT 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.

Learn more at fraserhealth.ca

Supporting a loved one?

“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.”

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

• 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.

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OVERDOSE PREVENTION

A traumainformed approach to substance use Fraser 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:

16 OVERDOSE PREVENTION RESOURCE GUIDE

• think ahead about what you want to discuss but avoid saying everything you 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 fraserhealth.ca & Canada.ca.

OVERDOSE PREVENTION

Patients help break cycles by driving their own care in Hope Barriers have been broken in Hope, says the community’s physician who treats substance abuse patients.

Dr. Aseem Grover said their interdisciplinary approach to treating patients has helped people with opioid use disorder and concurrent mental health issues feel more welcome, and more willing to look for help. It’s been hard work, he says, but it’s been worth it.

“We have broken down the barriers, literally,” he said, and they’ve been able to see the numbers changing for overdoses here in the most recent numbers.

“We’ve really bolstered our efforts in Hope,” Dr. Grover said. Where the community has previously been in the top three for opioid overdoses in the province, the numbers have plateaued now and Dr. Grover said that is because those with substance abuse issues feel safer in the new specialist clinic.

“We’re overflowing,” he said. “They love us there and they really appreciate our approach.”

Hope has a harm reduction counsellor on hand, and they use the clinic at the Fraser Canyon Clinic on Wallace Street as a central hub for services in the community.

Treatment is more of a negotiation, with the patient “driving their own care.”

They are also working hard to de-stigmatize addictions and the people who

have them by simply changing the wording. Dr. Grover had one patient who immediately left an ER when he heard a health care worker refer to him as an addict. He was in the middle of a heart attack, but refused care after feeling stigmatized.

He showed up at the clinic instead.

He said everyone in the community needs to look hard at how they interact with people with substance use disorders. Hope has a larger number of Indigenous people from up the Fraser Canyon that come to Hope for services.

“It is imperative that we try our best to mindful of their culture, and their needs,” he said.

In Hope, anyone can connect with the Fraser Canyon Clinic at 222 Wallace Street, or 604-8699966.

The Hope and Area Transition Society also runs several addictions programs from Boston Bar to Hope.

Harm reduction supplies, including injection and smoking kits, naloxone kits and sharps containers can be picked up at the Public Health Unit at 444 Park St. Supplies can also be accessed at the neighbouring Hope and Area Transition Society office, at 400 Park St. Pacific Community Resources also does a weekly delivery of harm reduction supplies to communities between Chilliwack and Boston Bar. The organization can be reached at 604-7955994 or 604-798-1416.

For more information about the Hope and Area Transition Society, please visit them online at HopeTransition.org.

https://ranmission.ca/ OVERDOSE PREVENTION RESOURCE GUIDE

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OVERDOSE PREVENTION

FIRST NATIONS SUPPORT

Health inequities faced by Indigenous Peoples, have become front and centre From job and food security to mental health and wellness, the impacts of the COVID-19 pandemic are far-reaching and felt by all in British Columbia. As we learned more about the Coronavirus over the past year, and developed strategies to bring us back towards a sense of normalcy, the toxic drug crisis operated alongside us with its own tragic impact on our communities.

The First Nations population in BC saw a disproportionate increase in overdose deaths in 2020. Overall, First Nations people were lost due to toxic drugs at 5.3 times the rate of non-Indigenous people in BC. In the Fraser Salish region alone First Nations people make up 1.4 per cent of the total population, but represent 7.5 per cent of toxic drug deaths.

“The introduction of colonialism in Canada, its presence today, and the and health inequities faced

by Indigenous Peoples, have been a reality for many but have now become front and centre in the current national dialogue. For many communities the impact of past efforts to eradicate Indigenous culture, of which Residential Schools is only one example, were as far reaching as those of COVID-19 and resulted in historical intergenerational trauma. Current systems can lack the presence of traditional and cultural supports. COVID-19 safety forced communities to adapt ceremonies and traditions to manage health and wellness, and some harm reduction practices (such as not using alone) conflict with safety protocols. The need to find ways to stay safe, reduce harms and support people who are on their healing journeys, is paramount.

The First Nations Health Authority (FNHA) is part of a governance system with the vision of supporting healthy, self-determining and vibrant BC First Nations children, families and communities. Part of our responsibility is to serve as a health and wellness partner to directly provide culturally safe and trauma-informed cultural, emotional, and mental health services to First Nations communities in BC, and to provide connections to other services and organizations who do the same. FNHA’s approach to the toxic drug crisis is based on four pillars: • Prevent people who overdose from dying • Keep people safe when using • Create an accessible range of treatment options • Support people on their healing journeys These pillars guide various initiatives including: prevention measures through the distribution of Naoloxone kits, funding support such as direct billing for Opioid Agonist

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“FNHA’s “Increase the Support. Reduce the Harm” campaign features real stories and experiences from Indigenous individuals throughout BC”

Therapy Treatments, and the establishment of Indigenous Wellness Educator positions to facilitate community conversations about harm reduction.

On May 10, FNHA announced a new Harm Reduction Campaign to increase awareness and guide individuals to supports available to them throughout their journey.

The campaign directs to a multitude of services including overdose prevention and harm reduction services.

The inclusion of land-based healing programs support a reconnection and reclamation of traditional wellness practices. To learn more about the campaign, visit: https://harmreduction.fnha.ca For more information and links to resources and services available visit: www.fnha.ca/what-we-do/mental-wellness-and-substance-use/overdose-information/get-help VIRTUAL SUBSTANCE USE & PSYCHIATRY SERVICE • Provides individuals with access to specialists in addictions medicine and psychiatry.

CLIENTS • To get a referral to this service, please contact your health and wellness provider or (the First Nations Virtual Doctor of the Day) HEALTH AND WELLNESS PROVIDERS • For assistance or to make a referral, please call 1-833-456-7655

OVERDOSE PREVENTION HARM REDUCTION SITES & SERVICES • Best option for using substances safely during the pandemic • Telmexw Awtexw Treatment (Outpatient/Community based) 4690 Salish Way, Agassiz, BC 604-796-9829

• Virtual Doctor of the Day 1-855-344-3800 Medical support, Virtual Substance Use and Psychiatry Service. 7 days a week 8:30am - 4:30 pm FNHA Health Benefits 1-855-550-5454

NALOXONE ACCESS • Naloxone is an injectable medication that can save loved ones from dying of a drug overdose because it reverses the effects of an overdose from opioid drugs.

• Two options covered by First Nations Health Benefits: Speak to your Pharmacist, or visit your doctor and ask for a prescription.

• You can find a pharmacy and harm reduction service locations towardtheheart.com/site-finder

For assistance with system navigation and support connecting to resources in the Fraser Salish Region contact First Nations Health Authority System Support Line: 604-743-0635, systems.support@fnha.ca

LAND-BASED HEALING • Process to heal the heart by connecting with First Nations traditional ways and teachings. Creates connection to the land and offers skills, knowledge and connection through culture, language, traditional teachings and ceremonies.

• Traditional Healing Resources First Nations Health Authority www.fnha.ca/what-we-do/traditional- healing

ADDITIONAL REGIONAL SUPPORTS • Fraser Health Aboriginal Health Referral Line Refer or connect with a Fraser Health Aboriginal Health Liaison 1.866.766.6960 • Tsow-Tun Le Lum Society 24-hour support line for those struggling with addiction, substance misuse, and trauma, including residential school survivors.

1-888-403-3123 • Cultural Support: Elder in Residence Abbotsford & Chilliwack 1-236-886-6743

MORE NEEDS TO BE DONE

TO PREVENT ADDICTION AND HELP THOSE SEEKING RECOVERY.

Conservatives are calling for: Targeted strategies for specific populations, Indigenous peoples, and at-risk youth; Employer Awareness Programs to help recognize addiction and provide support for their employees; and Increased temporary financial supports to individuals undergoing treatment and their families.

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19

OPIOID OVERDOSE

HOW TO RESPO ND TO 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

STR SNORING or coughi or chok

BREATHING IS STOPPED OR SLOWER THAN EVERY 5 SECONDS

GIVE A BREAT

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 HA

Needle can go through clothes.

Never put it in the heart.

It will click and will retrac

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

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 els Have that perso while you prepa

OVERDOSE PREVENTION

RIGHT AWAY!

Overdoses are a medical emergency & n eed medical care.

RANGE G SOUNDS ing, gurgling, king sounds

A TH

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 KN UCKLES HARD AGAINST THE IR 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 T HEY WAKE UP : GIVE A BREATH

GER ARD

needle ct.

urself? oxone g breaths.

se 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 COV ERY 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

www.fraserhealth.ca/healthtopics For more information visit: www.viha.ca/mho/overdo se

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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 use concerns: 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

our community

s r e tt a m SUPPORTING THE HOSPITALS AND HEALTH CARE SERVICES IN THE EASTERN FRASER VALLEY FVHCF.CA ▪ INFO@FVHCF.CA ▪ 1 877 661 0314 32900 MARSHALL RD, ABBOTSFORD BC

Facing today’s challenges for a better tomorrow Mental illness and substance abuse touch every part of our community, including university campuses.

UFV has been helping students cope with mental health and addiction issues through harm reduction programs, Naloxone training, and counselling.

As we invest in the safety and well-being of our community, we’re also investing in tomorrow. UFV students are future social workers, policy makers, and health care professionals who will address societal challenges, including substance abuse and the overdose crisis.

If you are a student who is struggling, help is available.

Call 1-844-741-6389 or visit here2talk.ca.

If you would like to support our student mental health programming or community-based research with a donation, contact giving@ufv.ca.

OVERDOSE PREVENTION RESOURCE GUIDE

23

OVERDOSE PREVENTION

HIDDEN POPULATION

Opioid crisis videos filmed in Chilliwack focus on ‘hidden population’ 3-part series on overdose prevention aims to change stigma attached to opioid users and their families A three-part video series on overdose prevention will spread the word that the vast majority of fatalities happen at home, not on the street.

It’s the “hidden population” of users and their loved ones that Pacific Community Resources Society (PCRS) in Chilliwack is targeting with the videos, said Jodi Higgs, manager of Chilliwack Health and Housing Centre, which is part of PCRS. “Those are the phone calls we get… the wives, the more to help the friends and family members over the past moms. They’re desperate.” year and a half.

When Higgs and her staff saw the stats last year from Initially the money was going to be used to host events at Fraser Health and BC Coroners Service, they realized the the worksites where the majority of that hidden population majority of people in the eastern Fraser Valley dying from would be – construction industries, factories, car lots – and substance overdose (75 per cent) are family men aged 29 to where people would be informed about the crisis and get 49 who are married with kids, and adult children who still training on how to use a naloxone kit. live with their parents (or have returned home to live with When the pandemic hit and places started shutting their parents). down, plans changed and PCRS decided to create a series of They are not homeless – they live in stable environments, videos called The Hidden Crisis. They are part of a number are high-functioning and hold down of friends and family services they’re good jobs. offering called Take My Hand.

“It really hit us hard that in order They reached out to Justin Booth “Those are the phone to reach the hidden population, we of Dock Visual Media to take on the calls we get… the have to reach the friends and family project. of these folks,” Higgs said. “They are “Justin is so creative and forwives, the moms. the ones who are closest, the ones ward-thinking,” Lloyd said, adding who know or may suspect but are They’re desperate.” he was “really intuitive” with the afraid to broach those topics, and message they wanted to get across in they are the ones that can really make the videos. a difference in the stigma and the shame.”

The first video (above) was released on YouTube on July 5 The most common thread in that hidden population is the and it talks about the overdose crisis within the hidden popshame, said program supervisor Kim Lloyd. ulation. Higgs and Lloyd explain what they hope to achieve: “They don’t want their neighbours to know, they don’t to reduce overdose by creating safe and shame-free spaces want their church community to know, they don’t want their in peoples’ homes. other family members to know, so it’s kept very hush-hush at The second video features two Chilliwack paramedics the expense, perhaps, of losing a loved one,” she said. who speak about their experience showing up at homes for By the time those family and friends get enough courage overdose calls. They also talk about naloxone and the Lifeto seek help, they are desperate and their family is falling guard app for those using. The app is activated (timer is set) apart. by the user before they take their dose and after a certain “It’s heartbreaking,” Lloyd said. Thanks to thousands of amount of time, if the user does not stop the timer a call is dollars in grants, PCRS in Chilliwack has been able to do a lot send straight to 911.

24 OVERDOSE PREVENTION RESOURCE GUIDE

OVERDOSE PREVENTION The third video is a “lived experience” where a Chilliwack man who’s in recovery tells his story.

All three videos were filmed in Chilliwack. The dates for the other two videos have not been released.

Snippets of the three videos were put together to create a trailer that was shown during the UBC Let’s Talk Overdose international conference in June.

When they submitted the video to the conference organizers, they were “absolutely blown away,” Higgs said, adding it was later awarded the best video at the conference.

Higgs said they are hoping the videos give friends and family “the support they need to put their own emotion aside in order to walk alongside their loved one. That’s how the shame will be reduced.”

“I think ultimately we want to change the stigma that’s attached both to the families and the substance users. I hope they pick up the phone and call the number that’s provided,” she said.

To see the first video, go to youtube.com/watch?v=ZR4zW-o1bNM, or go to the PCRS_BC YouTube channel.

PCRS in Chilliwack (45921 Hocking Ave.) also offers in-person group sessions for family and friends, naloxone training workshops, one-on-one counselling and more. Call 604-7955994 for more info, or 604-798-1416 to register for a free naloxone training workshop. Folks can also pick up free naloxone kits at that location.

Did you know?

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: n Reduce hepatitis and HIV n Reduce overdoses and deaths n Educate about safer sex and sexual health and increase condom use n Reduce injection substance use and used needles in public places n Increase referrals to treatment programs and services n Increase employment and reduce crime n 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

Mindfulness and Stigma Labels reduce us to a single description or identity where the richness and complexity of our true nature is lost and forgotten.

Labels can lead us to disconnection - from ourselves, from life and from life-giving connection.

Just take a moment and think of the labels that you carry inside and how they negatively impact you.

Naming, on the other hand, has the power to enhance and illuminate, bringing us more in line with our deepest selves. Think of a moment when something about you was properly named and how seen and understood you felt.

Let us be mindful of how thoughts and words have the power to lift or diminish.

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

“Stigmatization contributes to 26 OVERDOSE PREVENTION RESOURCE GUIDE

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,“someone who uses cocaine or a person who struggles with cocaine use.”

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

• Not all substance use is addiction, and not all use of illicit substances would meet the criteria for a substance use disorder. As helpers, when we preemptively use this frame to talk about substance use, we can potentially limit the ways in which we can support the person we care about.

• 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

Call it a haircut ministry with a twist Joseph Sikora and his Street Thug Barbers service a different kind of clientele, one most people would rather turn a blind eye to than extend a helping hand.

Not Sikora.

Each Sunday he offers his haircutting services to Abbotsford’s homeless population. And since COVID-19 put a crimp in his clippers many months ago, he has been providing food for the hungry as a way to keep in touch with those on the street.

Sikora knows all about that life.

He suffered from addiction for 25 years and lived hand-to-mouth on the streets of Kelowna, having lost his family, his wife and his son.

After nearly a dozen overdoses, Sikora had reached the end of his rope.

“I was a junkie – just as bad, if not worse, as any here. I was so broken and I needed to make some changes.”

Looking at an extended prison sentence, Sikora was offered a final chance to get healthy by attending a long-term treatment centre in New Brunswick, thousands of miles away from the bad influences he was constantly surrounded by in Kelowna.

He grabbed the lifeline, and everything changed. He fought and won custody of his son and met a loving and supportive partner.

“My life is completely different,” he proudly says.

While in treatment, Sikora picked up a set of clippers and began to cut hair. He needed to do something selfless, and to serve others.

Attending church one day while still on the east coast, Sikora was shown a video of the homeless getting haircuts. Upon returning to

B.C., he sought out Vancouver-based Street Thug Barbers founder Cam Sterling. After their meeting, Sikora knew what he had to do.

“I decided this is where I needed to be.”

Initially by himself, Sikora eventually took on a volunteer, Candace Rathy.

He describes her as a woman “with a big heart.” And one also with the ability to cut hair.

From their humble beginnings, they have attracted more volunteers and are starting to see growth on their Facebook account. They have also teamed up with The Santa Steve Project, and are now able to dedicate Wednesday nights to feeding the homeless.

Unlike soup kitchens or other brick-and-mortar establishments, Sikora and his fellow volunteers go to the various homeless camps to hand out food and water.

“We walk the trails handing out food,” he says.

Sikora credits his faith in sustaining him and for helping him in his mission.

“It’s a total God thing,” he says.

“We needed water, and – poof! – three skids of water show up. This is the God factor.”

Street Thug Barbers are not funded by any level of government.

People have donated online and Sikora is hoping to increase donations, especially cash.

People often underestimate the difficulty of proper hygiene for those living rough. Sikora knows that “when you look good, you feel good,” but the haircut is really just a means to talk to those with addictions or mental-health issues.

“While they are sitting in our chair, we get a chance to tell them our story and they get to tell us theirs,” he explains.

Sikora will often alert Riverside Shelter staff to meet with the homeless who are ready to commit to detox.

“We’re trying to instill dignity in people,” he says. “It’s so hard to get into detox.”

His end goal is to one day start a detox. He knows the power it has to change lives.

“If there is just one person I can get out, it will be worth it.”

Abbotsford Street Thug Barbers can be reached through their Facebook channel. For those looking to help out or donate goods or money, Sikora can be reached at 604-751-6458.

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Path given doesn’t dictate the path taken For Mission youth Helena May, the road to addic-

tion started young. She has many happy memories from childhood, but with her father in and out of prison, the burden of caring for her sibling started to take its toll.

At age 12, Helena was drinking with an older crowd, and by 16 she was dealing drugs and living on the streets. But Helena’s story did not end there.

Her life took a dramatic pivot when she encountered a few key adults – particularly Youth Unlimited’s Scott Guitard.

In Grade 8, older teens befriended Helena. Coping with their own struggles, they often brought her to a party house.

“They’d be drunk by 8 a.m., before school,” said Helena.

Older youth coxed Helena to become increasingly involved in illicit and adult activities.

“I knew it was wrong, but I looked up to them.”

By 16, Helena was dealing drugs, convinced she had no other options for work. Lost in a fog of mental health concerns and addiction, and enduring fights with her mom that became violent, she left home.

“I felt like my family didn’t want me and I had nowhere to go,” she said. “I wasn’t proud of my addiction, so I felt like the streets were where I belonged.”

Helena fought to get out of the cycle and went into detox, but struggled to stay sober with unhealthy influences surrounding her.

After missing most of her Grade 9 school year, Helena was placed at Fraserview Learning Centre School, which was “the best thing that could have happened,” she said.

While there, Helena met Youth Unlimited (YU) youth worker Scott Guitard, who had noticed Helena’s footwear was falling apart. Beyond providing a new pair of shoes, Scott forged a relationship with Helena – one of encouragement, support, and a much-needed introduction to Mission Youth House (MY House), a critical resource for homeless youth.

Helena began to frequent the facility. Whether to eat, shower, or get medical advice, MY House was where Helena felt safe.

YU youth workers became a constant in her life.

With a continuum of care surrounding her, Helena found the strength to completely change her life.

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Mission’s Helena May has overcome teen addiction and homelessness.

Submitted Photo

“She’s always been outgoing and friendly,” said Scott. “I was thrilled to see her making healthier choices and become a part of our community.”

Today, Helena remains clean and sober, with a blossoming career as an education assistant. Helena continues to give back. She’s held numerous internships (including at MY House) supporting youth facing the same challenges she had. Through Helena’s resilience and self-belief, she continues to prove that success and recovery is possible.

“I don’t know where I’d be without MY House,” said Helena. “It was here when I needed something to eat and needed a safe person to talk to. I’m very grateful.”

About My House: MY House is a community collaborative run by a local team including: Youth Unlimited, Mission Community Services, Fraser House, Hope Central, Matsqui-Abbotsford Impact, District of Mission, SD75, MCFD and Xyolhemeylh. *Youth Unlimited supports at-risk and homeless youth: www.youthunlimited.com.

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REDUCING STIGMA

Dispelling the myths about BC’s overdose epidemic When the public thinks of people dying from drug overdoses in the province, they picture needles floating in street puddles, not gainfully employed men dying alone in their homes.

Kat Wahamaa, regional liaison for Moms Stop the Harm and project co-ordinator for Mission’s Overdose Community Action Team, lost her son to an overdose in 2016.

She said the conversations around fatal drug “overdoses” – a term she doesn’t even like – are rife with misconceptions about what’s actually happening.

“They’re being poisoned by toxicity in the illicit supply,” Wahamaa said. “It’s in every kind of socio-economic level …

Sometimes, you wouldn’t even know they’re drug users.”

She said the problem is not that people are taking too much, but that criminal elements control the game. The cutting and cross contaminating of the supply (and not just opioids) with drugs like Fentanyl is what is killing people, she said.

While the deaths do occur in marginalized populations living on the streets, they are not representative of who is dying, according to Wahamaa.

Conflating the issue with homelessness misses the scope of the problem, she said, describing how drug use is also prevalent in trades people working long hours.

Throughout the pandemic, the provincial health authorities deployed an evidence-based approach towards limiting the spread of COVID-19, but Wahamaa said it’s upsetting the same scientific rigour isn’t applied to the overdose crisis.

One response was evidence based, the other is ideology based, she said.

“We know what works,” Wahamaa said, adding the problem is one of “political will.”

“If we have a COVID outbreak, we don’t seek the public’s opinion on how to respond to it. We let the public-health professionals craft the response. And that’s exactly what we need right now.”

She said the solutions have been agreed upon for decades: Overdose prevention sites detached from service providers; health professionals prescribing a safe pharmaceutical-grade drug supply; and a decriminalization policy integrated into the health system.

While Portugal’s decriminalization of all drugs in 2001 is the most famous example, many other jurisdictions have followed suite, Wahamaa said, “Canada doesn’t need to re-invent the wheel.”

And B.C. health professionals have been prescribing users with regulated versions of street drugs, such as Dilaudid,

In 2021, 85 per cent of the overdose deaths have occurred indoors, with 56% occurring in private residences.

Kat Wahamaa, the project coordinator for the Mission Overdose Community Action Team and a member of Moms Stop the Harm.

since spring, 2020. The program, Safer Supply, was a direct response to the increasing toxicity as borders closed during COVID. But more needs to be done, according to Wahamaa. She said little province-wide adoption by health authorities has occurred, prescribers weren’t up-to-date with the policy, users found it difficult to navigate, and some of the drugs offered did not work as substitutes.

“None of these drugs are unusual. They’re being produced and used (legally), and it’s like, we’ve just made a demarcation between, this is legal, and this is illegal.”

Substance use is not going anywhere, Wahamaa said, and the arbitrary lines between illegal and legal drugs often have dubious origins. Opium, she describes, was made illegal over 100 years ago as a racist, anti-immigrant policy to target Asians.

One of the goals of Moms Stop the Harm is get people to understand the evidence of the overdose crisis, before it leads to the death of a family member, Wahamaa said.

“Tough Love is a terrible thing. It’s a terrible thing, I’d feel really sad for parents who bought into that,” she said.

“The antidote is connection, not being stigmatized, and not (hitting) rock bottom.

“If you’re dead, you can’t recover.”

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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 mutual support lost their children from people to drug-related A safe supportive space. Be who have been harms. inspired by hope, empowered there and are with understanding and Explore options still struggling supported by peers.

Whether it’s spirwith addiction Call 1-833-898-6200 itual support, counissues. 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

Fraser Health Family & Friends Support Group

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

OVERCOMING ADDICTION

Overcoming addiction is a battle no one has to handle alone.

In Agassiz, Harrison Mills and Harrison Hot Springs, Agassiz-Harrison Community Services offers its substance use program to those in need.

The AHCS Substance Use program is aimed to promote community well-being. AHCS works in conjunction with several organizations – the RCMP, Probation, MCFD, Youth Inclusion Programs and Employment Services to support local prevention programs.

AHCS’s Substance Use program offers a number of services: • One-on-one counselling for individuals, couples and families affected by substance use.

• Group or one-on-one support and education for students

in the Fraser Cascade School District 78. Educational programs focus on prevention, substance use and effects with a strong focus on high-risk youth attending Agassiz Centre for Education.

• Identifying possible cross addictions and concurrent disorders with as-needed referrals to further, specialized support.

• Out-patient treatment for youth and adults.

Referral forms for AHCS’s Substance Use program are available online at agassiz-harrisoncs.ca.

The Sts’ailes Community Wellness Office is working together with First Nation Health Authority, The Children Youth Mental Health

Substance Use collaborative and other Fraser-Salish First Nations Communities to provide an alcohol and drug treatment program called Telmexw Awtexw.

Telmexw Awtexw focuses on residential school survivors, intergenerationally affected Indigenous people and those struggling with other life issues, helping members of the community “come to terms with their past, present traumas to hopefully position them for future rewards.”

Anyone who wants to access any Telmexw Awtexw services should contact the Sts’ailes Community Wellness Office at 604796-1282 or email sarah.kinshella@stsailes.com.

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Be a Good Samaritan 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

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. For more information visit: www. canada.ca/en/health-canada/services/ opioids/about-good-samaritan-drugoverdose-act.html 32 OVERDOSE PREVENTION RESOURCE GUIDE

The Hope and Area Transition Society runs several programs relating to overdose prevention and addictions stretching from Boston Bar to Hope.

Adult Substance Use Support This program provides one-to-one support to individuals who are substance using or affected by a family member or loved one’s substance use.

Various groups are offered and drop-in services are available.

They can conduct screening and assessment, treatment plans, referrals and prevention support. The program works within a harm-reduction approach and addresses the individual/family through a bio-psych-social-spiritual model.

Youth Substance Use Support and Outreach This outreach service is provided for youth up to age 24 who are experiencing substance use issues or affected by someone else’s substance use. This program uses a harm-reduction approach and a bio-psych-social-spiritual model. Services will be conducted by screening and assessment, treatment plans, referrals and prevention support.

Mental Health Substance Use Community Outreach Program These are early intervention programs that address fundamental health and well-being of vulnerable individuals. Through an outreach, mobile approach the promotion of healthy living and social connectedness will be offered. Advocacy and referrals will be offered.

Substance Use Prevention & Health Promotion Program This program includes early intervention, treatment and support services for children, youth and their families through a multi-partner, community-based program that utilizes a resiliency education approach to support the development of children and young people’s capacities toward wellness.

It is a school-based program designed to assist school personnel, youth and their families with issues regarding drug prevention and intervention. The program provides primary prevention, early intervention and community development in an attempt to reduce the incidence of alcohol and drug problems within the school community and the community-at-large.

Harm Reduction Supplies For anyone looking for harm reduction supplies including injection and smoking kits, naloxone kits and sharps containers, they can be picked up at the 444 Park St. public health unit. Supplies can also be accessed at the neighbouring Hope and Area Transition Society office, at 400 Park St. Pacific Community Resources also does a weekly delivery of harm reduction supplies to communities between Chilliwack and Boston Bar. The organization can be reached at 604-795-5994 or 604-798-1416.

For more information about the Hope and Area Transition Society, please visit them online at HopeTransition.org.

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NALOXONE TRAINING

Naloxone training helps friends and family be ‘part of the solution’ A Chilliwack agency has been training friends and family members of people struggling with substance use.

Pacific Community Resources Society (PCRS) in Chilliwack is educating those closest to the people who are using opioids by offering up free “friends and family” naloxone training workshops every Tuesday.

“It’s needed. It’s unfortunate that it’s needed, but it’s needed,” said Kim Lloyd, program supervisor with Chilliwack Health and Housing Centre, which is part of PCRS. On June 22, Lloyd was giving hands-on training to folks by using mock naloxone kits.

“The people who are overdosing are not who you think they are,” Lloyd said. They are the “unseen,” the “hidden population,” they are family men with kids.

“We’re in the midst of an overdose crisis,” added manager Jodi Higgs.

“When we think about the overdose crisis and overdose deaths, we think about the people living on the street.

Although those folks are also overdosing, the disproportionate number of people who are dying in the Eastern Fraser Valley, 72 per cent of them are in their own homes.”

The majority of that 72 per cent are family men aged 29 to 49 who are married with kids, and adult children who still live with their parents (or have returned home to live with their parents).

“It affects anyone at any time,” Lloyd said, adding that opioids have become more dangerous over the years.

“The drugs on the street are toxic.

They’re poisonous. They are tainted with all kinds of chemicals,” Lloyd said.

“Nothing is pure anymore.”

“Free workshops offered every Tuesday for friends, family of opioid users” Those unknown chemicals in the opioids can result in multiple doses of naloxone being needed in an overdose. There are three doses of naloxone in one kit, but Lloyd said it’s “not uncommon” to need four or five, or even 10 doses of naloxone. She recalled one person needing 11 doses.

Lloyd pointed out naloxone is not

harmful, and it is safe to administer it to someone who is not overdosing.

“I appreciate having the opportunity to get a kit and learn how to use it and hopefully be a part of the solution,” said Amber Callaghan, who was trained that day. “Awareness and reducing stigma, it’s all so important.”

The training sessions are about an hour long and everyone walks away with a naloxone kit.

People can sign up for a “friends and family” naloxone training session (held every Tuesday as needed) by calling the Chilliwack Health and Housing Centre (45921 Hocking Ave. in Chilliwack) at 604-798-1416. The centre also has free naloxone kits and support for substance users, as well as their family and friends.

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THE RIGHT WAY TO DISPOSE OF NEEDLES The safe disposal of needles saves others from getting hurt accidentally. Fraser Valley Healthshares 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

MICHAEL DE JONG MLA Abbotsford West

• 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:

Here to Connect You with Provincial Government Supports.

604-870-5486

www.mikedejongmla.bc.ca mike.dejong.mla@leg.bc.ca 34 OVERDOSE PREVENTION RESOURCE GUIDE

• Wash the injured area with soap and warm water as soon as possible • Apply an antiseptic and a clean bandage; dispose of the needle safely • Call your local public health unit: Abbotsford: 604-864-3400 Agassiz: 604-793-7160 Chilliwack: 604-702-4900 Mission: 604-539-5500, Hope: 604-860-7630 • Visit your local emergency department or primary care provider, preferably within 24 hours Visit https://www.fraserhealth.ca/health-topics-a-to-z/ mental-health-and-substance-use/harm-reduction/ safe-sharps-disposal-locations#.YPHP2-lKjOI for more information. Learn more about harm reduction at: fraserhealth.ca.com

OVERDOSE PREVENTION

Resource Guide CRISIS AND SUPPORT LINES If you or someone you know needs help, call one of the numbers below: • 9-1-1 if you are in an emergency.

• 8-1-1 for non-emergency information on how to access alternatives to toxic drug supply and substance use services • 1-800-SUICIDE (1-800-7842433) if you are considering suicide or are concerned about someone who may be.

• 310Mental Health Support at 310-6789 (no area code needed) for emotional support, information and resources specific to mental health.

• Kid’s Help Phone at 1-800-6686868 to speak to a professional counsellor, 24 hours a day.

• Alcohol & Drug Information and Referral Service at 1-800663-1441 (toll-free in B.C.) or 604-660-9382 (in the Lower Mainland) to find resources and support.

FRASER HEALTH CRISIS LINE: 604-951-8855 or 1 877-820-7444

HEALTH, SUBSTANCE USE AND RELATED SERVICES ABBOTSFORD PUBLIC HEALTH UNIT

Naloxone distribution, fentanyl screening, sterile supply distribution. Supply distribution and disposal for all the HU 7298 Hurd Street, 1st floor Mission, BC 604-814-5500 AGASSIZ-HARRISON PUBLIC HEALTH UNIT, Naloxone

distribution, fentanyl screening, sterile supply distribution, syringe

collection & disposal. 7243 Pioneer Ave, Agassiz, BC 604-793-7160

ABBOTSFORD DRUG WAR SURVIVORS Peer led overdose

prevention & harm reduction services including episodicoverdose prevention services, naloxone distribution, fentanyl screening, sterile supply distribution, referrals to other services, advocacy & support, syringe collection & disposal.

Contact Program Coordinator Drug War Survivors Matsqui-Abbotsford Impact Society. 778-201-8899 brittany@drugwarsurvivors.com www.drugwarsurvivors.com AGASSIZ-HARRISON COMMUNITY SERVICES

Community substance use services provides individual, couple, family and group counselling for anyone, youth and adult who is open to exploring their relationship to substances as well as for those impacted by a family member’s substance misuse. Concerns can be related to any mood-altering substance, such as alcohol, street drugs, club drugs, inhalants, prescription and over-the-counter drugs.

7086 Cheam Avenue, Agassiz BC 604-796-2585 www./agassiz-harrisoncs.ca/ services/individuals ARCHWAY COMMUNITY SERVICES

Opioid Agonist Treatment, often referred to as OAT, provides people who have an opioid use disorder with treatment using medications like buprenorphine/ naloxone (Suboxone) and methadone.

202-31943 South Fraser Way, Abbotsford, BC 604-850-5106 www.archway.ca/program/ abbotsford-addictions-centre

CHILLIWACK ADDICTION & PREVENTION SERVICES

45921 Hocking Avenue, Chilliwack, BC 604-795-5994 www.caps@pcrs.ca /pcrs.ca/our-services/chilliwackaddictions-and-preventionservices-caps CHILLIWACK GENERAL HOSPITAL

45600 Menholm Road, Chilliwack, BC 604-703-6976 CHILLIWACK PUBLIC HEALTH UNIT

Naloxone distribution, fentanyl screening, sterile supply distribution, syringe collection & disposal. 45470 Menholm Road, Chilliwack, BC 604-702-4900 CONCURRENT DISORDERS PROGRAM FOR YOUTH Fraser Health The concurrent disorders program provides services, information and support to youth who are experiencing a combination of emotional and/or psychiatric problems in addition to problematic substance use.

We have concurrent disorders therapists to support youth who: • Receive services through child and youth mental health teams or • Are receiving services at a community youth substance use services program Youth concurrent disorders therapists work alongside the youth to provide assessment, planning, connection to psychiatry, and brief counselling.

East services: Mission, Abbotsford, Chilliwack, Hope, Agassiz, Boston bar. 604-897-3571 HOPE HEALTH UNIT,

Naloxone distribution, fentanyl screening, sterile supply distribution, syringe collection & disposal. 444 Park Street, Hope, BC 604-860-7630

FRASER EASTAAC

Fraser Health Rapid Access to Addiction Care (RAAC) clinic provides low-barrier, responsive care to patients with substance use concerns with an aim of assessment, initial stabilization and transition to communitybased clinics and services.

The Rapid Access to Addiction Care clinic services will include addiction medicine assessments for any substance use issue, including alcohol.

45600 Menholm Road, Chilliwack, BC 604-703-6976 FRASER EAST RAAC 7298 Hurd Street, Mission BC 604-814-5600 FRASER HEALTH’S OPIOID AGONIST TREATMENT Clinics provide comprehensive care and facilitate connections to other healthcare services and community supports (e.g. Primary Care, counselling etc.). 202-31943 South Fraser Way, Abbotsford, BC 604-743-0543 aac@archway.ca www.archway.ca MISSION COMMUNITY HEALTH CENTRE 7298 Hurd Street, Mission, BC 604-814-5600

COMMUNITYBASED RECOVERY SERVICES AND SUPPORTS ARCHWAY COMMUNITY SERVICES Offers harm reduction services including fentanyl screening, sterile supply distribution, naloxone distribution, syringe collection & disposal.

202-31943 South Fraser Way, Abbotsford, BC 604-850-5106 www.archway.ca/program/ abbotsford-addictions-centre

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OVERDOSE PREVENTION FRASER HOUSE SOCIETY Providing substance use services in Mission and surrounding areas since 1967.

We provide substance use services for adults, youth and families including counselling for family members affected by someone’s substance use: Adult counselling | Youth counselling | Rural Connections from Hatzic Prairie to Harrison Mills – office in Deroche| Prevention and Health Promotion | Expressive Arts Therapy We also currently operate three grants through the Community Action Initiative: Community Counselling – Outreach| Mission Overdose Community Action Team | Resilient Teens – supporting girls and awareness around alcohol use. fraserhouse. org FB– Fraser House Society.

Instagram@fraserhousesociety 604-826-6810 HOPE AND AREA TRANSITION SOCIETY Provides services, advocacy and education to build resiliency, empowerment and inclusion.

In addition offers harm reduction services including fentanyl screening, sterile supply distribution, naloxone distribution, syringe collection & disposal.

400 Park Street, Hope, BC 604-869-5111 www.hopetransition.org/ addiction/ LIFEGUARD APP is a life-saving app designed to automatically contact emergency services if a use becomes unconscious or unable to function in the event of an overdose. It can

RESOURCE GUIDE be downloaded on Apple or Android systems. Using Lifeguard App should always be your last option. Over 90% of all overdoses occur when users are alone, in their own spaces – We encourage you to use in a safe place, and with a friend or family member close by.

Lookout Housing and Health Society Naloxone Distribution, fentanyl screening, sterile supply distribution, referrals to other services, mobile harm reduction services; syringe collection & disposal. Riverside Shelter Lookout Housing and Health Society. 604-776-2424 / 604308-8296 www.lookoutsociety.ca MISSION FRIENDSHIP CENTRE SOCIETY Specific for Indigenous people.

33150 First Avenue, Mission BC 604-826-1281 www.missionfcs.ca

LOOKOUT HOUSING AND HEALTH SOCIETY Naloxone Distribution, fentanyl screening, sterile supply distribution, referrals to other services, mobile harm reduction services; syringe collection & disposal. Riverside Shelter Lookout Housing and Health Society. www.lookoutsociety.ca 604-776-2424 / 604-308-8296 MATSQUI – ABBOTSFORD IMPACT SOCIETY Youth and young adult specific service 12-24 years in addition offers harm reduction services including fentanyl screening, sterile supply distribution, naloxone distribution.

33228 Walsh Avenue Abbotsford, BC 604-853-1766 referrals@impactabby.com. www.impactabby.com/ MISSION ALANO CLUB N Railway Ave, Mission, BC Alano Club: 604-826-5744

HELPING TO COMBAT OVERDOSE • Substance Use Counselling for Youth & Adults • Harm Reduction Supplies Call us.

• Naloxone Training/Drug Checking We can help.

• Friends & Family Support 604.795.5994 • Indigenous Wellness & Peer Programs • Youth Treatment • Referrals to Treatment We have the services and the support to help you or your loved one decrease the need to use substances or decrease the risk of overdosing

mission@youthunlimited.com m.me/missionyouthhouse

www.pcrs.ca 36 OVERDOSE PREVENTION RESOURCE GUIDE

http://www.missionyouthhouse.com

OVERDOSE PREVENTION 24 hour AA Hotline: 604-864-1552 missionalanoclub@ telus.net/FB We are a nonprofit organization focused on helping to meet the needs of Aboriginal and NonAboriginal people and families who are making a transition to the urban community. To provide a central and suitable facility where counselling, support and referral services will be provided.

Providing referral services to those coming into a 12 step program or for those still suffering who are looking for help to provide a safe and friendly environment.

MISSION COMMUNITY SERVICES SOCIETY Providing the community with a variety of harm reduction services, including provision of clean drug use supplies, delivery of Take Home Naloxone, safe disposal, inappropriate sharps pickup, education, advocacy, and overdose prevention locations for both youth and adults accessing services.

33179 2nd Avenue, Mission, BC 604.826.3634 To learn more about our programs go to https:// missioncommunityservices.com/ MISSION OVERDOSE COMMUNITY ACTION TEAM The Mission Overdose Community Action Team (MOCAT) brings together community members (service agencies, people with lived experience, family members, business owners, healthcare providers) to facilitate local partnerships, coordinate programs and services, address gaps, peer advocacy, provide public education and plan for a compassionate community response. www.stopodmission.ca FB/StopOverdoseMission

NATIONAL OVERDOSE RESPONSE SERVICES 1-888-688-NORS(6677) nors.ca “NORS is a peer-run, peer-led overdose prevention hotline.

NORS makes overdose support available to Canadians 24/7.

Call the hotline from anywhere in Canada before using for affirming, confidential, respectful support.”

PACIFIC COMMUNITY RESOURCES SOCIETY Naloxone distribution, fentanyl screening, sterile supply distribution, referrals to other services, mobile harm reduction services; syringe collection and disposal.

45921 Hocking Avenue, Chilliwack, BC 694.795.5994 c. 604.798.1416 www.pcrs.ca PACIFIC COMMUNITY RESOURCES SOCIETY Intensive day treatment, or the Day, Evening, Weekend for Youth (DEWY) program, assists youth 13 to 18 years of age who are working to overcome substance use issues. The goal of the program is to help youth reduce or abstain from substance use through intensive group counselling and activities.

Expect group sessions that are flexible to your needs. Attend the core program from Tuesday to Friday from 1 p.m. to 5 p.m.

Drop-in weeks occur periodically.

You can also expect to learn about personal health and safety, goal setting, personal values, relationships, substance misuse, coping skills and relapse prevention. 604-951-4821 dewyprogram@pcrs.ca PHOENIX SOCIETY Witnessed consumption, naloxone distribution, fentanyl screening, sterile supply distribution, referrals to other services, mobile harm reduction services, syringe disposal & collection.

RESOURCE GUIDE 32883 South Fraser Way, Abbotsford, BC 604-854-1101 RUTH & NAOMIS We provide an array of services to assist members of our community who may be struggling with poverty, homelessness, addiction and mental health concerns.

We provide a safe, structured and shame-free environment for people to regain their physical, mental relational and spiritual health. www.ranmission.ca 46129 Princess Avenue Chilliwack, BC 604.795.2322 towardtheheart.com site-finder HR supplies locations, overdose prevention sites, THN distribution sites, safer sex supply locations etc. across BC. Fraserhealth.ca/ health-topics-a-to-z/mentalhealth-and-substance-use/ emergency-help-for-mentalhealth-and-substance-useconcerns#.YPHdAklKiUk – inks to regional crisis lines etc.

WARMZONE Gender specific (female only) witnessed consumption, , naloxone distribution, fentanyl screening, sterile supply distribution, referrals to other services, mobile harm reduction services; peer distribution, syringe collection & disposal.

33264 Old Yale Road, Abbotsford, BC 604.746.3301

YOUTH AND FAMILY SERVICES FOUNDRYBC.CA Young people aged 12-24 and their caregivers can use the app to drop-in or schedule a virtual counselling appointment, find peer support, join a youth group or caregiver group or browse our library of tools and resources.

101- 32555 Simon Avenue, Abbotsford, BC 604-746-3392 info@foundryabbotsford.ca

MISSION COMMUNITY SERVICES YOUTH SERVICES 33179 2nd Avenue, Mission, BC 604-826-3634 https:// missioncommunityservices.com/ MISSION YOUTH HOUSE 7368 Proctor Street, Mission 604 - 287-7200 www missionyouthhouse.com (MY House) is dedicated to HELPING YOUTH FEEL AT HOME. At MY House, youth can shower, do laundry, eat, find refuge, access medical care, substance use care, counseling and other support in various ways. All youth between ages 12-24 are welcome. MY House is a collaborative run by many service organizations in Mission.

1 A place to get cleaned up and have a shower 2 Access to laundry 3 Healthy, warm meals 4 Non-judgmental adults to talk to MY House will address these needs. In addition, MY House will offer access to youth focused medical services in a safe and accessible environment.

COUNSELLING AND ADDICTION TREATMENT SUNSHINE COAST HEALTH CENTRE PERSONALIZED MENTAL HEALTH AND ADDICTION TREATMENT We provide 24-hour medical care, psychiatry, psychology, nutrition and fitness support, specialized body work, and a host of other services. We’ve been developing licensed and accredited mental health programs with an extraordinary record of high quality care since 1991 and Sunshine Coast Health Centre is one of six treatment facilities we oversee. Our men’s programs brings together the collective expertise of highlytrained professionals to provide

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OVERDOSE PREVENTION

The Salvation Army Outreach Team Abbotsford/Mission At the Centre of Hope or under an overpass, our Outreach Team come alongside those living in difficult circumstances, offering hope and the support necessary to equip individuals to overcome the challenges that stand in their way. If you or a loved one need assistance - please reach out to us.

Please donate today: centreofhope.net/donate thank you for your support 604.852.9305

www.centreofhope.net

RESOURCE GUIDE evidence-based treatment for high-functioning and motivated men struggling with their mental health. 12 step treatments are not a part of our programming.

1.866.487.9010 https://www. sunshinecoasthealthcentre.ca/ VALIANT RECOVERY CENTERS At Valiant Recovery we treat the roots behind addictions.

We provide the highest level of 1on1 sessions available, offering up to 12 private sessions per week. On top of this we add a full compliment of daily sessions focusing on topics like, Anxiety & Depression, Grief and Loss, Anger, Co-Dependency, Trauma, 12 step, Relapse Prevention. Our Individualized program allows us to address your specific situation and circumstances.

1.877.958.8247 www.valiantrecovery.com

WESTMINSTER HOUSE 228 7th Street, New Westminster, BC 1-866-524-5633 We Help Women Recover Westminster House provides affordable addiction recovery and treatment programs for youth girls and women healing from addiction. https://www. westminsterhouse.ca/ ADULT & TEEN CHALLENGE BRITISH COLUMBIA Teen Challenge helps men and women aged 18+ to overcome addictions by developing the whole person within the context of a residential facility.

Students learn character and leadership development skills, health and life skills, and have the opportunity to acquire some vocational training.

1.888.575.3930 https://teenchallengebc.com/ locations/chilliwack-mens/

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OVERDOSE PREVENTION

About this project Recognizing the tragic consequences the current opioid crisis is having on our community we wanted to find a way to respond in a meaningful way - to make a difference.

Inspired by our sister publications in Washington State and Vancouver Island and the work being done by so many here at home, we created the Fraser Valley Overdose Crisis Prevention Guide.

This publication would have not have been possible without our community partners.

Thank you all for partnering with us in making a difference.

dom e e r F from addiction starts here

Fraser Valley Overdose Prevention Guide published by Black Press Media.

Group Publisher, Carly Ferguson Fraser Valley 604-851-4538 / carly.ferguson@blackpress.ca Advertising, Kelly Myers Abbotsford News 604-851-4519 / kelly.myers@abbynews.com Publisher, Tara Hiebert Chilliwack Progress 604-702-5560 / tara.hiebert@theprogress.com Publisher, Karen Murtagh Mission City Record 604-820-5453 / karen.murtagh@missioncityrecord.com Editorial: Ken Goudswaard, Abbotsford News/ Hope Standard, Adam Louis, Agassiz Harrison Observer, Paul J. Henderson, Jenna Hawke, Chilliwack Progress, Kevin Mills & Patrick Penner Mission City Record Design & Video Services, Black Press Media Magazine Division, Victoria BC

We are here to support you through your journey Freedom from life controlling issues and addiction is within reach.

Overdose doesn't have to be the end, there is hope.

One-year Live-in Programs Surrey Women's Centre | Chilliwack Men's Centre | Okanagan Men's Centre Community Office Day Programs Williams Lake | Cranbrook | Abbotsford

Call or apply now at 888.575.3930 teenchallengebc.com/apply-now

WHAT WE DO: Oat CliniC addiCtiOns COunselling FOOd & ClOthing PrOgram

JOIN US:

harm reduCtiOn VOlunteer2WOrk PrOgram hOusing/shelter reFerrals VOlUNteer | DONate | Share OPeN: MONDay - FrIDay 10aM - 3PM w w w. F F t S P. O r g

ABBOTSFORD: 2564 CleARBROOk RD | 604.746.9797 MAPle RIDGe: 101 - 22347 lOuGheeD hwy | 604-380-1608

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TOXIC DRUGS ARE KILLING IN B.C. Talking to someone about substance use can be hard, but it could also be the most important conversation you will ever have.

Compassion and respect are key. We can help you to find the right words.

DOWNLOAD THE LIFEGUARD APP If you or someone you know uses drugs, Lifeguard App provides one more way to stay safer. This life-saving app can automatically connect you to emergency responders if you become unresponsive.

Download it for FREE on your smartphone or tablet.

VISIT WWW.STOPOVERDOSEBC.CA FRASER VALLEY MLA’S ARE HERE TO HELP. REACH OUT! Pam Alexis, MLA Abbotsford - Mission | pam.alexis.MLA@leg.bc.ca | 604.820.6203 Dan Coulter, MLA Chilliwack | dan.coulter.MLA@leg.bc.ca | 604.702.5214 Bob D’Eith, MLA Maple Ridge - Mission | bob.deith.MLA@leg.bc.ca | 604.476.4530 Kelli Paddon, MLA Chilliwack - Kent | kelli.paddon.MLA@leg.bc.ca | 604.858.5299